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ANATOMICAL  INVESTIGATIONS, 

COMPRISING 

DESCRIPTIONS  OF  VARIOUS  FASCIA 

OF  THE 

HUMAN  BOHY; 

The  DiscoTeries  of  the  Manner  in  which  the  Pericardium  is  formed  fi'om  the  Superficial 
Fascia;  the  Capsular  Ligament  of  the  Shoulder  Joint  from  the  Brachial  Fascia;  and  the 
Capsular  Ligament  of  the  Hip  Joint  from  the  Fascia  Lata. 

TO  WHICH  IS  ADDED 


AN  ACCOUNT  OF  SOME  IRREGULARITIES  OF  STRUCTURE 

AST) 

MORBID  ANATOMY; 

WITH  A DESCRIPTION  OF  A NEW 

ASTATOMICAZ.  TABLE. 

♦- 

BY  JOHN  D.  GODMAN,  M.  D. 

LECTURER  ON  ANATOMY  AND  PHYSIOLOGY; 

EDITOE  OP  THE  JOUBNAt  OF  FOREIGN  MEDICIKE  ; PROFESBOB  OP  PHT9IOL06Y 
TO  THE  PHILADELPHIA  MUSEUM  ; MEMBER  OF  THE  ACADEMY  OP  NATURAL 
SCIENCES  ; HONORARY  MEMBER  OF  THE  MEDICAL  SOCIETIES  OF  PHILADEL* 
PHIA,  MARYLAND,  BALTIMORE,  LEXINGTON,  CINCINNATI,  PITTSBURG,  &C. 


PHILADELPHIA: 

H.  C.  CAREY  & I.  LEA.—CHESNUT  STREET. 

Ts2l 


EASTERN  DISTRICT  OP  PENNSYLVANIA,  TO  AVIT  : 


BE  n'  REMEMBERED,  that  on  the  eighteenth  day  of 
A $ June,  in  tlie  forty-eighth  year  of  the  Independence  of  the 

■'  II  'C  United  States  of  America,  A.  D.  18‘24, 

L.  S.  , 


* 


!l 


' I H.  C.  CAREY  AND  I.  LEA, 

!i:  sir Sr*!?;* 

of  the  said  district  have  deposited  in  this  office  the  title  of  a book,  the  rigfit 
whereof  they  claim  as  proprietors,  in  the  words  following,  To  wit: 


“ Anatomical  Investigations,  comprising  descriptions  (J  various  fasciae  of  the 
Human  Body:  The  Discoveries  of  the  Manner  in  which  the  Pericardiiyn 
is  formed  from  the  Superficial  P'ascia ; the  Capsular  Ligament  of  the 
Shoulder  Joint  from  the  Brachial  Fascia;  and  the  Capsular  Ligament  of 
the  Hip  Joint  from  the  Fascia  Lata.  To  which  is  added  an  account 
of  some  irregularities  of  structur.-  and  Morbid  Anatomy;  with  a description 
of  a new  Anatomical  Table.  By  John  I).  Godman,  M.  D.  lecturer  o^_ 
Anatomy  and  Phisiology;  editor  of  the  Journal  of  Foreign  Medicine; 
professor  of  Physiology  to  the  Philadelphia  Museum  ; member  of  the 
Academy  of  Natural  Sciences  ; honorary  member  of  the  Medical  Societies 
of  Philadelphia,  Maryland,  Baltimore,  Lexington,  Cincinnati,  Pitts- 
burg, Sc.” 

In  conformity  to  the  act  of  the  Congress  of  the  United  States,  entitled,  “An 
Act  for  the  Encouragement  of  Learning,  by  securing  the  copies  of  Maps,  Charts, 
and  Bofvks,  to  the  authors  and  proprietors  of  such  copies,  during  the  times 
therein  mentioned; — And  also  to  the  act,  entitled,  “An  Act  supplementary  to 
an  Act,  entitled  “ An  Act  for  the  Encouragement  of  Learning,  by  securing  the 
copies  of  Maps,  Charts,  and  Books,  to  the  authors  and  proprietors  of  such 
copies  during  the  times  therein  mentioned,”  and  extending  the  benefits  thereof 
to  the  arts  of  designing,  engraving,  and  etching  historical  and  other  prints. 

D.  CALDWELL, 

derh  of  the  Eastern  District  of  Pennsylvania. 


STTOENTS  OF  MEDICINE 


IN  PARTICULAR, 

AND  LOVERS  OF  IMPROVEMENT  GENERALLY, 

TBESE  EIBST  FBUITS  OF  THE 
OP  STUDYING  AND  TEACHING 

ANATOMY 

ARE  MOST  RESPECTFULLY 

DEDICATED 

BY 


THE  AUTHOK. 


' / 


Digitized  by  the  Internet  Archive 
in  2016 


https://archive.org/details/anatomicalinvest01godm 


INTRODUCTION 


The  following  investigations  were  begun  without 
reference  to  any  system,  and  without  the  slightest 
wish  to  support  any  preconceived  opinions.  The 
conclusions  drawn  were  unavoidable,  even  at  first 
inspection,  and  their  correctness  was  more  firmly 
established  by  every  subsequent  examination.  The 
researches  were  originally  made,  in  every  instance, 
in  the  presence  of  a class  of  students,  most  of  whom 
had  attended  two  courses  of  anatomical  lectures,  and 
were  considerably  experienced  in  dissecting.  They 
were  stationed  as  near  as  possible  to  the  table  and 
requested  to  suffer  nothing  to  pass  them  as  ascer- 
tained, of  which  they  were  not  entirely  satisfied  by 
the  demonstration.  They  saw  every  touch  made 
with  the  knife,  and  were  thoroughly  able  to  judge 
of  the  difference  between  what  really  existed,  and 
what  might  have  been  accidentally  produced.  The 
results  of  all  the  investigations  made  in  the  presence 
of  the  class,  and  before  the  members  of  the  profes- 
sion especially  invited  to  witness  them,  exactly  cor- 
responded with  the  descriptions  here  given.  There 
was  no  ambiguity  either  in  the  continuation,  extent, 
or  density  of  the  Fasciae  and  processes. 


INTRODUCTION. 


\ f 

It  is  much  easier  to  demonstrate  the  whole  of 
these  structures,  than  to  convey  an  accurate  idea  of 
them  by  description,  as  to  the  repetition  of  techni- 
cals, and  the  reader’s  want  of  precise  recollections 
of  the  parts  referred  to,  necessarily  give  an  ap- 
pearance of  obscurity  to  a minute  anatomical  detail. 

The  mode  of  teaching  anatomy  by  a pure  Analy- 
sis, which  it  has  been  my  happiness  first  to  intro- 
duce and  establish  by  the  fairest  experiment,  is  the 
only  method  which  can  free  us  from  the  trammels 
of  long  reigning  prejudice,  or  the  dominion  of  an- 
cient errours,  that  have  become  prescriptively  es- 
tablished by  frequent  repetition  in  systematic 
works.”  By  this  method  the  teacher  is  always 
placed  in  the  condition  of  a learner,  and  no  autho- 
rity is  accredited  but  demonstration — no  book  is  va- 
lued until  its  descriptions  have  been  tested  by  a rigid 
scrutiny,  in  direct  comparison  with  the  structure  as 
fairly  exposed,  and  competently  observed.  This 
appeal  from  hooTcs  and  authorities  to  nature,  dis- 
perses the  clouds  which  have  too  long  involved  the 
science  of  Anatomy — removes  the  difficulties  that 
have  impeded  the  advances  of  the  inquiring  student, 
and  opens  the  way  to  improvement,  discovery,  and 
truth.  In  order  to  satisfy  such  as  may  not  have 
read  the  exposition  of  this  method,  which  was  pub- 
lished a few  months  since,  the  following  extract  may 
be  advantageously  presented. 


INTROUUCTIOK. 


vii 


lu  consequence  of  a careful  investigation  of  tbe 
modes  of  teaching  anatomy,  I have  been  induced  to 
resort  solely  to  the  method  of  Analysis  or  decompo- 
sition. The  subject  is  placed  before  the  learner 
untouched  ; the  knife  is  not  used  to  clear  obstruc- 
tions from  the  way  of  the  teacher,  'previous  to  the 
lecture.  The  student  sees  the  relation  of  parts — 
the  Anatomy,  as  it  is  left  by  the  hand  of  nature : he 
observes  the  manner  in  which  they  are  to  be  suc- 
cessively removed — he  sees  the  situation  and  com- 
pany with  which  they  are  always  to  be  found,  and 
perceives  that  in  this  mode  of  examination  there  are 
no  difficulties  to  impede  his  progress,  but  inatten- 
tion or  neglect.  The  body  is  decomposed  by  the 
knife  in  his  sight,  and  he  soon  acquires  a clearness 
of  information  on  the  connexion  of  parts  existing  in 
the  living  system,  which  enables  him  at  any  mo- 
ment to  recollect  what  is  to  be  encountered  in  any 
portion  of  the  frame.  The  physiology  he  learns 
does  not  consist  of  a collection  of  scraps  and  frag- 
ments relative  to  each  part  separated,  but  it  is  the 
whole  that  can  be  learned,  from  the  whole  in  combi- 
nation. Should  the  teacher  even  be  inadequate  to 
the  task  of  telling  him  all  that  is  necessary,  yet  as 
the  student  sees  the  veritable  anatomy  for  himself, 
his  subsequent  reading  is  always  aided  by  recol- 
lecting the  actual  condition  of  the  structure.” 

In  fact  we  believe  no  cause  has  acted  more  pow- 


1. 


Viii  INTRODUCTION* 

erfully  in  retarding  the  advancement  of  the  science 
of  medicine,  than  the  injudicious  mode  of  teaching 
anatomy  synthetically.  In  this  way,  we  can  easily 
account  for  the  limited  and  unphilosophical  views 
of  physiology  and  pathology  which  have  been  given 
to  the  world.  One  teacher  acquires  a habit  of  pay- 
ing an  exclusive  attention  to  the  nerves,  and  all  his 
views  are  nervous — another  scrutinizes  the  arteries, 
and  all  the  theories  he  forms  are  injiammatory ; a 
third  studies  the  veins,  and  congestions  and  en- 
gorgements are  the  night-mares  that  oppress  him  ; a 
fourth  pores  over  the  absorbents,  and  he  is  in  conti- 
nual dread,  lest  the  balance  of  the  system  should 
be  destroyed ; a fifth  looks  entirely  to  the  muscles 
and  his  mind  can  perceive  nothing  but  alternations, 
of  laxity  and  tension,  of  tonic  and  clonic  contrac- 
tions, of  debility  and  spasm  I’’ 

— — In  teaching  anatomy  by  the  analytic  me- 
thod, the  teacher  has  not  so  good  an  opportunity  of 
making  the  parts  loole  beautiful  as  in  the  ordinary 
modes  of  instrnction.  He  must  of  necessity  show 
the  structure  exactly  as  it  is ; and  must  be  content 
with  the  advantages  his  class  receives  from  correctly 
understanding  the  subject.  While  learning  the  re- 
lation of  parts,  the  class  is  in  general  too  usefully 
and  agreeably  employed,  to  think  of  the  sights  they 
might  have,  were  the  lecturer  at  liberty  to  prepare 
tliem  before  hand,  at  the  trifling  expense  of  destroy- 


li^TliObUCTlON.  IX 

itig  a few  fasciae  arteries,  veins,  nerves,  tendons  or 
muscles  ! It  is  true,  that  in  this  mode  of  teaching, 
the  lecturer  will  find  it  no  easy  task  to  commit  a 
lesson  to  memory,  and  he  may  occasionally  err  in 
his  descriptions ; yet  as  he  opens  the  faultless  vo- 
lume of  nature  before  the  eyes  of  his  class,  an  error 
in  Ms  speech  does  not  place  a veil  over  their  sight ; 
nor  does  an  inaccuracy  in  his  detail,  produce  any 
inaccuracy  in  tlieir  perceptions. 

The  discoveries  now  announced  are  the  immedi- 
ate fruits  of  the  adoption  of  this  method  of  teaching, 
and  their  importance  may  be  gathered  from  a con- 
sideration of  the  following  particulars.  The  fasciae 
of  the  human  body  have  heretofore  been  considered 
very  numerous,  and  in  a great  degree  independent 
of  each  other.  One  fascia  has  frequently  been  de- 
scribed under  many  different  names.  By  these  re- 
searches all  the  fasciae  liave  been  reduced  to  three, 
all  of  which  are  fairly  continuous  at  certain  points. 
We  show  that  all  the  fasciae  heretofore  described, 
(with  the  exception  of  the  temporal,  palmar  and 
plantar  aponeuroses)  are  offsets  or  processes  from 
these  three  fasciae.  The  first  and  most  striking  ad- 
vantage is  the  simplification  of  what  has  till  now 
been  unnecessarily  esteemed  complex.  By  explain- 
ing the  connexion  of  the  processes  with  the  parent 


* See  the  Introductory  Lecture  on  “Analytic  Anatomy,”  published  by 
the  class,  Feb.  182..t. 

B 


X 


INTRODUCTION.- 


fascise,  and  pointing  out  their  relations  with  tlic 
different  structures,  we  are  enabled  to  form  a clearer 
idea  of  the  natural  and  morbid  condition  of  the 
parts ; this  is  an  advantage  only  to  be  appreciated 
by  those  who  know  liow  miserably  inaccurate  the  or- 
dinary conclusions  relative  to  functions  are,  when 
drawn  from  the  knowledge  of  the  structure,  obtain- 
ed in  the  usual  synihetic  manner. 

The  discovery  of  the  formation  of  the  Pekic  a in- 
dium from  the  fascia  siiperficialis  removes  a great 
stumbling  block  from  the  path  of  the  student,  who 
is  inevitably  bewildered  when  he  tries  to  compre- 
hend bow  a delicate  serous  membrane,  the 
can  form  a strong  fibrous  capsule  such  as  the  Pe- 
ricardium, as  is  usually  taught. 

Py  demonstrating  that  the  sheaths  of  the  vessels 
are  formed  not  from  mere  cellular  substance  but  by 
processes  of  a dense  fibrous  membrane,  which  of- 
fer an  equal  resistance  to  the  dilatation  of  the  blood- 
vessels, a great  difficulty  is  removed,  which  has  long 
existed  relative  to  tlie  physiology  of  the  circulation  ; 
so  much  has  been  said  about  the  elasticity  of  the 
vessels  tiiat  many  have  been  induced  to  believe  them 
entirely  free  from  the  ordinary  laws  of  hydrostatics. 
The  formation  of  the  sheath  shows  us,  that  they 
must  be  when  distended,  nearly  in  the  condition  of 
rigid  tubes  ; this  enables  us  to  perceive  satisfactorily 
bow  an  impulse  given  by  the  heart  can  effect  with 


INTUOUUC  no\. 


XL 

the  slightest  loss  of  power,  the  whole  coliimii  of 
blood  from  the  centre  to  the  circumference  of  the 
system,  and  does  away  the  necessity  of  looking  for 
other  causes  than  the  heart  to  propel  the  circulating 
fluids. 

Among  the  most  interesting  parts  of  these  re- 
searches, is  the  demonstration  of  the  manner  in 
which  the  capsular  ligaments  of  the  great  joints  are 
formed.  I am  by  no  means  anxious  to  claim  great 
merit  for  proving  the  continuity  of  fasciae,  and  the 
connexions  thus  produced  between  diflerent  parts — 
although  Bichat  contented  himself  with  asserting 
that  the  fibrous  membrane  may  be  traced  into  the 
periosteum.  But  I do  expect  the  thanks  of  anato- 
mists and  physiologists  for  having  pointed  out  the 
mode  in  wdiich  the  capsular  ligaments  are  made  up 
•from  the  coverings  of  the  muscles,  and  thus  render- 
ing their  natural  conditions  more  intelligible  and 
opening  the  way  to  new  views  of  their  possible  si- 
tuations resulting  from  disease  or  accident.  I am 
sure  of  receiving  the  grateful  applause  of  every  un- 
prejudiced student  for  having  in  this  part  of  the 
science  substituted  simplicity  for  complexity  and 
regularity  for  confusion. 

Nor  is  it  pretended  that  this  subject  is  exhausted  ; 
other  investigators  may  make  such  discoveries  as 
■will  entitle  them  to  correct  and  modify  some  of  the 
details  herein  advanced.  But  we  have  repeated 


ii\Tli0JJUCT101s. 


xii 

tlie  examinations  too  frequently,  and  in  the  presence 
of  too  many  critical  judges,  to  have  any  fear  for  the 
general  principles  proposed.  With  a full  assurance 
that  a repetition  of  these  dissections  will  convince 
even  the  most  prejudiced,  they  are  offered  to  the 
professional  world,  and  we  await  with  pleasure,  the 
decisions  of  such  as  examine  for  themselves.  Those 
who  do  not  examine,  have  no  right  to  offer  any  de- 
cision, whatever  notions  they  may  entertain.  In 
matters  of  probability  men  may  judge  from  a state- 
ment of  the  reasons  for  and  against  a conclusion ; 
hut  when  facts  are  announced,  whose  existence  can 
be  established  or  denied  by  demonstration  and  ex- 
periment alone,  he  who  neither  experiments  nor  de- 
monstrates must  be  silent,  or  speak  in  vain.  We 
ask  no  man  to  voucli  for’^  the  truth  of  what  is 
here  advanced — we  Avish  all  to  examine,  and  their 
testimony  will  be  favourable. 

The  novelty  of  these  descriptions  will,  perhaps, 
be  the  greatest  impediments  to  their  general  accep- 
tation, for  it  has  been  very  correctly  remarked  by 
an  illustrious  anatomist,*  that  there  are  many  per- 

* Que  de  personnes  s'efirarouchent  de  la  seule  announce 
d’idees  nouvelles  ? Si  j’ai  la  conviction  qu’on  m’ait  attaque  sans 
in’avoir  cotnpris,  je  me  dispenserai  de  reponcire.  Car,  a quoi  bon 
se  tourmenter'  pour  prouver,  qu’on  a eu  raison  '■  Le  temps  met 
cliaqup  chose  a sa  place”. 


flEOFrnoY  8 VINT  Hii.aire. 


iNTHODUCTlOxN.  xlu 

SOUS  who  become  furious  at  the  mere  auuuuciatiou 
of  new  ideas like  him,  however  we  shall  wait 
patiently,  convinced  that  time  fixes  every  thing  in 
in  its  place. 


ANATOMICAL  INVESTIGATIONS. 


SECTION  I. 

The  Fascia  Siiperjlcialis, 

Various  parts  of  the  human  body  are  so  imper- 
fectly  and  obscurely  describedj  as  often  to  excite  a 
doubt  of  their  true  nature.  This  evil  is  of  great 
magnitude,  and  results  from  various  causes,  none  of 
which  are  so  active  as  a habit,  becoming  too  gene- 
ral, of  considering  the  structure  of  individual  tex- 
tures insulated  from  all  others  and  independent  of 
their  relations — as  concerned  in  a single  disease  or 
connected  with  a particular  operation  in  surgery. 

Hence  small  portions  of  the  same  membrane  arc 
known  by  different  names,  and  very  minute  de- 
scriptions are  given  of  each  separately,  so  as  to 
convey  to  the  mind  an  idea  of  several  distinct  mem- 
branes, where  there  is  in  reality  but  one.  Even  if 
this  conclusion  be  not  drawn  by  the  uninstructed, 
it  is  very  certain,  that  every  person,  from  mere 
reading,  infers  that  these  membrane.^,  fasciae,  &c. 
are  extremely  difficult  to  be  understood,  and  that  a 


AM  ATOAllCAL  IM  V KS-TItiATlOMSa 


iB 

Ihorough  knowledge  of  them  can  scarcely  be  ac- 
([Hired.  Some  pupils  are  so  strongly  impressed 
with  this  idea,  that  they  avoid  the  examination  of 
siicli  parts,  and  pass  them  hy,  as  things  on  which 
much  time  may  he  spent,  without  the  attainment  of 
aiij'  e([uivalent  good. 

The  tihroLis  membrane  Avliich  covers  the  whole 
of  the  trunk,  and  a very  considerable  part  of  the  ex- 
tremities of  the  body,  is  one  of  the  really  important 
and  perfectly  simple  structures,  wdiich  has  been 
made  difficult,  solely  by  considering  it  in  frag- 
ments, and  describing  those  with  most  tedious  mi- 
nuteness— though  without  any  compensating  clear- 
ness of  arrangement,  or  accuracy  of  detail.  With 
a 1 ope  of  exhibiting  this  part  of  anatomy  more 
advantageously  to  the  student,  and  of  removing 
some  of  the  obstacles  before  mentioned,  these  in- 
vestigations are  begun — and  should  the  effort  be 
followed  by  any  success,  the  author  Avill  be  en- 
couraged to  extend  his  attention  to  other  parts  of 
equal  importance,  which  hitherto  have  been  offered 
to  the  learner  under  a similar  veil. 

ily  making  a crucial  incision  through  the  integu- 
ments of  the  abdomen,  from  the  ensiform  cartilage 
to  the  pubis,  and  from  the  crest  of  one  ileum  to  the 
other,  going  no  deeper  than  the  loose  cellular  sub- 
stance, we  may  reflect  the  integuments  on  all  sides, 
so  as  to  leave  the  fascia  siiperficifdis  untouched- 


ANATOMICAL  INVESTIGATIONS. 


17 


If  we  then  lightly  make  another  crucial  incision^ 
we  divide  the  fascia  sujperficialis,  and  encounter  a 
layer  of  cellular  substance,  more  delicate  than  that 
which  lies  between  the  integument  and  fascia,  yet 
in  general  very  distinctly  perceptible.  By  dis- 
secting cautiously,  the  fascia  may  be  reflected  in 
every  direction,  though  it  can  be  done  with  more 
ease  where  it  lies  over  the  tendon,  than  where  it 
covers  the  muscular  fibre. 

Let  us  first  examine  the  inferior  part,  which  we 
shall  find  descending  towards  the  top  of  the  thigh, 
slightly  connected  by  the  intervening  cellular  tex- 
ture to  the  tendons  of  the  abdominal  muscles,  until 
it  reaches  Poupart’s  ligament,  to  the  external  or  iliac 
portion  of  which  it  is  more  closely  attached.  As 
we  approach  the  os  pubis,  near  which  it  covers  the 
spermatic  ring  and  cord,  the  handle  of  the  knife 
may  be  used  to  separate  it  from  the  tendons — and 
by  looking  mnder  the  fascia,  when  thus  raised, 
without  reflecting  it,  we  obtain  the  fairest  view  of 
the  real  character  and  situation  of  the  spermatic 
cord.  The  fascia  receives  a very  considerable 
thickening  near  the  pubes  from  the  lamina  of  cellu- 
lar substance  exterior  to  it — and  it  is  continued 
over  the  corpora  cavernosa  penis,  as  well  as  sends 
down  a strong  sheet  into  the  scrotum,  which  has  re- 
ceived the  name  of  Camper’s  ligament.  This  por- 
tion descends  obliquely  in  the  direction  of  the 

C 


18 


AXATOMICAL  IN  VESTIGATIONS. 


cord,  which  it  covers,  and  of  the  testicle,  which  it 
surrounds.  The  external  portion  passes  down- 
wards, over  the  whole  of  Poupart’s  ligament,  to 
the  upper  part  of  the  thigh,  lying  immediately 
under  the  integuments,  and  over  the  cluster  of 
lymphatic  glands  and  vessels,  which  fill  up  the  de- 
pression  below  Poupart’s  ligament.  As  it  ap- 
proaches the  top  of  the  thigh,  it  gradually  becomes 
thinner,  and  loses  its  regularity  of  texture,  verging 
to  the  appearance  of  common  cellular  tissue  : it 
may  still  be  traced  some  distance  down  the  inner 
part  of  the  thigh,  until  it  is  lost  in  common  cellular 
texture,  lying  in  contact  with  the  fascia  lata  and  in- 
teguments. We  may  next  raise  the  fascia  superfi- 
cialis  from  over  the  crest  of  the  ilium,  and  pursue 
it  backwards  to  the  spine,  and  we  may  follow  it 
downwards  covering  the  whole  of  the  gluteal  mus- 
cles, where  it  is  strengthened  by  large  additions  of 
cellular  texture.  As  we  approach  the  tubera 
ischii,  the  fascia  becomes  more  closely  attached  to 
the  surface,  and  in  many  instances  seems  to  termi- 
nate there.  This,  however,  is  not  the  case,  as  it 
may  be  followed  across  covering  the  whole  of  the 
perineum,  forming  the  strong  fascia,  which  presents 
to  the  knife  immediately  after  the  first  incision  in 
lithotomy.  We  trace  it  from  the  perineum  up- 
ward, until  we  lose  it  on  the  under  surface  of  the 
penis,  where  it  mingles  with  the  covering  which 


ANATOMICAL  INVESTIGATIONS.  19 

this  organ  derives  from  the  anterior  part  of  the 
fascia. 

Returning  to  the  central  part  of  the  abdomen, 
we  prosecute  our  dissection  upwards.  We  raise 
the  fascia  superficialis  from  the  tendinous  sheath  of 
the  rectus  with  facility,  but  find  it  so  closely  adhe- 
rent to  the  proper  coat  of  the  muscular  fibre,  as  to 
require  some  care  for  its  separation.  This,  how- 
ever, may  be  efiuected  with  comparative  ease,  and 
we  lift  it  from  over  the  lower  part  of  the  sternum 
and  pectoral  muscle,  and  from  the  superior  part  of 
the  external  oblique.  We  trace  the  fascia  with 
great  facility  towards  the  spine,  and  find  it  giving 
a strong  covering  to  the  muscles  of  the  back. 

When  we  raise  the  anterior  part  to  within  a 
hand’s  breadth  of  the  clavicle,  we  see  the  platysma 
myoides  is  on  the  outside  of  the  fascia,  and  in  im- 
mediate contact  with  the  integuments,  stretching 
obliquely  upwards  to  the  angle  of  the  jaw,  its  an- 
terior fibres  ascending  to  the  angle  of  the  mouth, 
and  the  posterior  in  many  instances  rising  to  the 
zygoma,  and  connecting  itself  with  the  outer  part 
of  the  orbicularis  oculi.* 

Having  removed  the  platysma  carefully,  we  then 

* As  this  first  section  was  sometime  ago  published,  I have 
thought  it  best  not  to  change  it  materially  in  this  work.  The 
truth  of  this  description  will  not  be  afiected  by  the  slight  raodifica- 
tions  made  after  other  more  careful  researches. 


A X A I'  O M I C A L 1 N Y E S r 1 G A T I O X S . 


20 

obtain  a view  of  the  superficial  facia  covering  the 
whole  of  the  neck,  ascending  in  front  to  the  edge 
of  the  chin,  where  it  is  lost  in  cellular  and  muscu- 
lar substance.  As  we  pass  towards  the  angle  of 
the  jaw,  we  find  it  rising  higher,  (though  thin,) 
covering  the  masseter  muscle,  attaching  itself  to 
the  zygoma  with  firmness,  and  extending  towards 
the  ear,  so  as  entirely  to  overlay  the  parotid  gland, 
and  prevent  us  from  obtaining  any  distinct  idea  of 
its  precise  figure.  From  the  back  and  upper  part 
of  the  zygoma  we  see  it  passing  up  on  the  outside 
of  the  temporal  fascia,  and  including  in  its  sub- 
stance the  anterior  auris  and  attollens  aurem.  The 
portion  covering  the  shoulders  and  back  of  the 
neck  continues  over  the  occipital  belly  of  the  occi- 
pito-frontalis,  and  may  be  traced  over  this  muscle, 
and  continuous  with  the  lateral  portion  until  the 
muscle  becomes  united  with  the  scalp. 

After  gaining  this  view  of  the  exterior  of  the 
superficial  fascia,  let  us  return  to  the  anterior  part, 
and  make  a careful  incision  from  the  centre  of  the 
sternum  to  the  centre  of  the  chin.  Then  we  reflect 
the  superficial  fascia  towards  the  shoulder,  and 
thus  uncover  the  sub-maxillary  glands  and  bellies 
of  the  digastric  muscles  above,  and  the  sterno- 
cleido-mastoideus,  throughout.  Tracing  the  fascia 
to  the  posterior  edge  of  this  muscle,  we  shall  find 
it  to  split,  or  form  two  portions,  the  anterior  of 


ANATOMICAL  IN  VESTIGATIONS. 


21 


which  (the  part  reflected)  doubles  immediately 
around  the  sterno-cleido-mastoidens,  and  goes  for- 
ward again  towards  the  trachea,  and  anterior  part 
of  the  neck,  covering  the  muscles  of  the  os  hy- 
oides,  &c.,  the  trachea,  and  thyroid  gland.  Be- 
low it  may  be  traced  the  edge  of  the  clavicle,  and 
above  the  os  hyoides  and  thyroid  cartilage.  The 
other  part  runs  outwards  and  backwards  from  the 
posterior  edge  of  the  mastoideus — extending  down- 
wards, attaching  itself  to  the  acromion  and  spine  of 
the  scapula,  ivhere  it  gradually  blends  with  the 
general  superficial  fascia  on  the  back.  Thus  the 
sterno-cleido-mastoideus  is  enclosed  in  a distinct 
sheath,  the  same  fascia  forming  both  the  deep  and 
superficial  covering  of  the  neck.  This  part  of 
anatomy,  although  it  may  have  been  known,  has 
never  been  described  with  precision,  and  1 may 
claim  the  merit  of  a discovery  with  much  less  dan- 
ger of  losing  my  title  than  has  occurred  in  the  case 
of  others.  Even  Colies,  with  all  his  minuteness, 
has  not  attended  to  this  really  beautiful  arrange- 
ment, which  enables  us  to  understand  the  anatomy 
and  pathology  of  this  region  with  much  more  clear- 
ness, than  if  we  considered  these  to  be  distinct 
structures. 

The  last  part  of  the  'fascia  superficialis  to  be 
traced  is  that  which  we  find  extending  from  the 
pectoral  muscle  and  clavicle  over  the  deltoid,  and 


22 


ANATOMICAL  INVESTIGATIONS. 


surroimding  the  muscles  of  the  arm,  continuing 
over  the  elbmv,  exterior  to  the  fascia  of  the  biceps 
muscle,  down  to  the  back  of  the  fingers. 

After  the  general  examination  of  the  extent  and. 
relations  of  the  fascia  superficialis,  we  may  with 
great  profit  attend  to  the  different  modes  in  which 
it  may  affect  the  conclusions  of  the  physician  or 
the  operations  of  surgery.  In  doing  this,  for  the 
sake  of  regularity,  we  may  begin  with  the  superior 
portion.  Here  we  may  observe  that  the  manner  in 
which  it  is  attached  to  the  zygoma  and  covers  the 
parotid  gland  will  prevent  us  from  readily  dis- 
covering a fluctuation.  The  peculiar  arrangement 
of  the  fascia,  which  encloses  the  mastoideus,  en- 
ables us  to  understand  why  a suppuration  of  this 
gland  always  breaks  anterior  to  the  muscle,  and  why 
the  matter  does  not  find  its  way  among  the  deeper 
seated  parts  of  the  neck.  If  Vv^e  consider  that 
the  portio  dura,  or  respiratory  nerve  of  the  face, 
comes  out  through  the  parotid  after  having  passed 
through  the  foramen  auditorium  internum,  we 
shall  not  be  surprised  at  the  extreme  pain  in  the 
ear  produced  by  an  inflammation  of  the  gland  which 
must  violently  compress  this  nerve  through  the  agen- 
cy of  the  fascia  superficialis  and  the  surrounding 
bony  structure.  The  anterior  portion  covering  the 
submaxill  ary  gland  will  exert  a pressure  of  the  same 
kind,  though  by  no  means  so  great,  as  the  surround- 


xiNATOM£CAL.  INVESTIGATIONS. 


23 


ing  parts  are  very  different  in  character.  Over  the 
pectoral  and  other  muscles,  this  fascia  will  neces- 
sarily exert  a similar  influence  when  tumours  form 
or  suppurations  ensue.  By  attending  to  the  differ- 
ences in  the  strength  and  degree  of  attachment  of 
this  fascia  in  various  situations,  we  may  form  a 
tolerably  correct  idea  of  the  course  that  matter 
would  follow.  Certain  diseases  convince  us  clearly 
of  this,  as  may  be  learned  from  the  following  dis- 
section made  during  the  last  winter,  A patient 
died  of  infiltration  of  urine,  succeeding  to  a rup- 
ture of  the  urethra  in  perineo.  The  urine  had 
gradually  made  its  way  upward,  and  had  passed 
into  the  scrotum,  which  was  in  a state  nearly  ap- 
proaching to  putrefaction.  The  urine  had  follov/ed 
the  course  of  the  cord,  and  had  separated  the  fascia 
superficialis  from  the  tendon  of  the  external  ob- 
lique, considerably  above  the  crest  of  the  ilium. 
Here  the  attachment  was  too  close  to  permit  its 
passage  farther.  Below  it  was  bounded  by  the  at- 
tachments to  the  tubera  ischii,  and  on  the  upper 
and  inner  part  of  the  thigh  by  the  attachment  to 
the  fascia  lata. 

It  is  almost  unnecessary  for  me  to  dwell  on  the 
importance  of  the  anterior  portion  of  the  fascia  to 
the  surgeon.  In  hernia  it  is  frequently  very  much 
thickened,  and  its  appearance  entirely  altered  by 
inflammation.  In  scirrhus  of  the  testicle  it  may 


24 


ANATOMICAL  INVESTIGATIONS. 


also  be  changed  in  character,  and  by  this  change 
add  materially  to  the  unfavourableness  of  our  prog- 
nosis. Whenever  we  are  to  operate  in  this  region, 
we  should  recollect  that  the  fascia  superficialis 
comes  into  view  as  soon  as  we  have  divided  the  in- 
teguments and  a portion  of  cellular  substance. 

That  part  of  the  fascia  superficialis  which  covers 
the  gluteal  muscles  is  also  well  worthy  of  consid- 
eration. Sometimes  the  matter  of  lumbar  abscess 
makes  its  way  out  of  the  ischiatic  notch,  following 
the  cellular  substance  surrounding  the  vessels.  In 
one  case,  which  fell  within  my  own  observation, 
the  appearances  presented  by  a collection  of  matter 
were  such  as  to  deceive  several  skilful  surgeons  as 
to  the  real  nature  of  the  case.  It  appeared  to  be  a 
circumscribed,  or  an  encysted  tumour.  There  was 
nothing  in  the  history  of  the  case  to  induce  a sus- 
picion of  its  real  nature,  so  that  it  was  resolved  to 
remove  it  with  the  knife.  A crucial  incision  was 
made  and  the  flaps  dissected  back,  so  as  to  disco- 
ver the  surface  of  a large  sac,  occupying  nearly  the 
whole  extent  of  the  buttock.  When  the  operator 
began  to  cut  round  the  base  of  the  tumour,  the  na- 
ture of  the  disease  was  at  once  seen.  An  opening, 
made  by  the  knife,  let  out  a vast  quantity  of  flaky 
matter  peculiar  to  scrofulous  abscesses,  and  the 
patient,  in  a few  weeks,  exhibited  signs  of  hectic, 
soon  succeeded  by  colliquative  diarrhoea  and  death. 


ANATOMICAL  INVESTIGATIONS.  25 

This  case  will  point  out  the  propriety  and  impor- 
tance of  making  a small  puncture  with  a needle  or 
a lancet  in  every  tumour  of  doubtful  character,  as 
advised  by  Pott  in  the  case  of  diseased  testicle, 
and  by  Abernethy  as  a general  rule.  Had  it  not 
been  for  this  posterior  portion  of  the  superficial 
fascia,  the  matter  of  this  abscess  M'ould  have  found 
its  way  down  to  the  extremity  of  the  limb,  as  it 
would  have  been  entirely  external  to  the  fascia 
lata.  It  is  solely  by  the  acquisition  of  a thorough 
knowledge  of  the  relations  of  parts,  that  a surgeon 
or  physician  can  properly  decide  on  the  true  cha- 
racter of  diseases. 

The  fascia  superficialis  is  neither  very  vascular 
nor  sensible.  Its  arteries  are  derived  anteriorly 
from  the  extreme  branches  of  the  intercostal,  mam- 
mary and  epigastric  arteries — posteriorly,  from  the 
branches  which  nourish  the  muscles  of  the  back. 
There  are  in  front  two  veins  descending  from  the 
navel  to  the  top  of  the  thigh,  running  over  Pou- 
part’s  ligament,  which  are  the  only  vessels  worthy 
of  notice,  though  they  are  not  very  important. 
They  help  to  return  the  blood  sent  out  by  the  su- 
perficial arteries,  and  empty  into  the  great  vein  be- 
low the  ligament.  The  nerves  of  this  fascia  are 
very  few,  although  it  is  perforated  in  many  places 
by  the  extreme  branches  of  the  intercostal  nerve. 
It  cannot  be  supposed  that  a fascia  of  this  kind  is 

I) 


26  ANATOMICAL  INVES'ITGATIONsi. 

possessed  of  any  remarkable  degree  of  sensibility, 
or  that  it  is  supplied  with  a greater  number  of 
nerves  than  is  required  to  maintain  it  in  proper 
relation  with  the  rest  of  the  system. 

I am  well  aware  that  in  many  cases  the  fascia 
superficialis  does  not,  at  first  view,  appear  continu- 
ous to  the  entire  extent  herein  described.  That  in 
certain  situations  it  is  more  closely  attached  to  the 
subjacent  parts  than  in  others,  is  also  well  known 
—yet  as  we  frequently  find  subjects  in  which  the 
closest  of  these  attachments  offer  no  obstruction  to 
the  raising  of  the  fascia  as  above  pointed  out,  we 
see  no  reason  why  it  should  not  be  described  as  a 
general  fascia,  which  it  really  is,  instead  of  a num- 
ber of  disconnected  fragments,  scarcely  reducible 
to  order,  and  almost  unintelligible.  By  the  for- 
mer method  we  avoid  confusion,  and  assist  the 
learner  to  form  correct  opinions  of  its  general  cha- 
racter and  uses  : by  the  latter,  a needless  perplex- 
ity is  occasioned,  and  the  advances  of  the  student 
are  injuriously  retarded. 


ANATOMICAL  INVESTIGATIONS. 


27 


SECTION  II. 

Fascim  of  the  JV* 2ck. 

One  of  the  most  interesting  arrangements  obser- 
ved, is  that  of  the  facia  superficialis,  on  the  front 
and  lateral  parts  of  the  neck.  The  first  section 
contains  a description  of  the  manner  in  which  the 
sterno-cleidomastoideus  is  included  by  the  external 
and  internal  layer  of  the  superficial  fascia,  which 
last  has  heretofore  been  considered  to  be  the  deep 
seated  fascia  of  the  neck.  By  my  more  recent  ex- 
aminations, the  correctness  of  what  was  advanced 
relative  to  the  sheath  of  the  mastoideus  was 
throughout  confirmed — But  I have  been  led  to  re- 
mark that  the  arrangement  of  the  fascia  below  this 
muscle  is  very  diiferent  from  what  is  usually  repre- 
sented, and  that  its  true  character  has  not  hitherto 
been  made  known. 

In  order  to  make  the  description  as  clear  as  pos- 
sible, it  will  be  necessary  to  repeat  a small  part  of 
what  was  before  stated  concerning  the  fascia,  as  it 
passes  from  over  the  thorax  to  ascend  on  the  neck, 
and  also  .slightly  to  modify  the  description. 


2b 


anatomical  investigations. 


If  we  begiu  about  midway  between  the  clavicle 
and  fifth  rib,  to  raise  the  fascia  superficialis  to- 
wards the  clavicle,  we  shall  find  when  we  arrive  at 
the  origin  of  the  platysma  myoides,  that  a layer  of 
the  fascia,  which  is  thin  and  delicate,  goes  over 
the  surface  of  this  muscle,  while  a stronger  and 
denser  layer,  continuous  with  the  part  raised  from 
the  thorax,  runs  underneath  the  platysma,  and  ex- 
tends upwards  to  the  zygoma.  By  this  the  masse- 
ter  muscle  and  parotid  gland  are  covered,  and  their 
figures  concealed.  Should  we  now  commence  in 
the  centre  and  dissect  the  platysma  myoides  care- 
fully ofiF,  we  have  a fair  view  of  the  external  layer 
of  the  fascia  superficialis,  leaving  out  of  the  ac- 
count the  slight  covering  of  the  platysma  myoides. 

Next  make  an  incision  over  the  centre  of  the 
trachea,  extending  from  the  base  of  the  os  hyoides 
to  the  top  of  the  sternum  through  this  external 
layer.  It  may  then  be  raised  easily,  towards  the 
outside  of  the  neck,  until  w;e  have  fairly  laid  bare 
the  whole  of  the  sterno-cleidomastoideus.  If  we 
cut  off  the  origins  of  this  muscle,  and  raise  it  care- 
fully from  its  bed  tovVards  its  insertion,  without 
cutting  the  fibre  of  the  muscle  or  the  subjacent  fas- 
cia, we  shall  see  that  the  portion  of  fascia  traced 
from  the  front  of  the  neck  over  the  last  named 
muscle,  splits  just  at  the  outer  edge  of  the  mas- 
toideus,  sending  one  layer  outwards  and  back- 


ANATOMICAL,  INVESTIGATIONS.  29 

wards,  (over  the  muscles  of  the  neck  and  head) 
while  the  other  runs  inwards  and  forwards  towards 
the  centre  of  the  trachea,  and  thus  forms  the  lower 
part  of  the  sheath  for  the  mastoideus.  This  layer, 
immediately  under  the  mastoideus,  covers  the  inter- 
nal jugular  vein,  the  omo-hyoldeus,  and  near  the 
centre  of  the  neck  lies  over  the  sterno-hyoideus. 
Thus  far  my  researches  were  extended  in  the  for- 
mer essay,  but  it  will  be  seen  that  the  subsequent 
inquiries  have  led  to  a more  extensive  acquaintance 
with  the  true  character  of  the  fascia  of  the  neck, 
and  enable  us  to  understand  the  manner  in  which 
the  sheath  for  the  great  vessels  is  formed.  To  be 
convinced  of  the  fact  that  all  the  fasciae  of  the  neck 
are  processes  of  the  fascia  superficialis — to  be  as- 
sured that  there  are  sia?  distinct  layers,  or  processes 
of  this  fascia  on  the  front  of  the  neck,  and  that  the 
sheath  for  the  vessels  is  formed  by  horizontal  slips 
stretching  from  the  anterior  to  the  posterior  por- 
tion, above,  below,  and  between  the  jugular  vein, 
carotid  artery  and  eighth  pair  of  nerves,  it  will  be 
sufficient  to  pursue  the  following  order  of  exami- 
nation. 

Suppose  the  superficial  layer,  or  portion  covering 
the  mastoid,  to  be  turned  back  as  far  as  the  outer 
edge  of  this  muscle,  and  the  muscle  raised  so  as 
to  exhibit  the  continuity  of  the  outer  and  second 
layer.  Then  make  an  incision  over  the  sterno 


30  anatomical  investigations. 

hyoideus  (through  the  second  layer,)  from  its  ori- 
gin to  its  insertion,  and  raising  this  layer  towards 
the  outer  part  of  the  neck,  we  shall  find  it  form- 
ing a beautiful  sheath  for  the  omo-hyoideus,  pre- 
cisely analogous  to  that  made  by  the  superficial 
portion  for  the  mastoideus,  but  being  oblique  to  suit 
it  to  the  position  of  the  omo-hyoideus.  Tracing 
this  layer  to  the  outer  edge  of  this  muscle,  we  raise 
the  muscle  from  its  bed,  without  injuring  the  subja- 
cent fascia,  and  then  we  have  this  under  portion, 
lying  over  the  thyroid  gland,  and  immediately  co- 
vering the  sterno-thyroideus  muscle. 

Let  an  incision  next  be  made  through  this  third 
layer,  over  the  sterno-thyroideus  in  its  length,  and 
we  raise  the  fascia  as  far  toward  the  outside  of 
the  neck  as  to  the  carotid  artery,  and  then  we  shall 
see  how  beautifully  the  process  for  the  omo-hyoi- 
deus sets  off  from  this  third  layer,  which  is  on  a 
level  with  the  jugular  vein,  and  continuous  with 
the  sheath  of  the  mastoid  muscle. 

There  is  yet  another  distinct  process  going  off 
from  the  fascia,  where  it  touches  the  lower  edge 
of  the  carotid  artery.  This  fourth  process  runs 
forwards  and  inwards,  covers  the  thyroid  gland, 
and  stretches  across  the  front  of  the  trachea  under 
the  sterno-thyroideus.  If  this  layer  be  turned  back 
towards  the  carotid  artery,  and  the  vein  and  artery 
be  raised  by  pulling  the  superficial  fascia  upwards, 


ANATOMICAL  INVESTIGATIONS. 


Si 


we  see  a perpendicular  process  of  the  fascia,  reach- 
ing from  the  under  surface  of  the  vessels  to  the 
muscles  lying  immediately  on  the  bodies  of  the 
vertebrsB.  This  perpendicular  process  is  double. 
One  part  goes  outward  and  backward,  till  it  reaches 
the  transverse  processes  of  the  vertebrae  where  it 
is  attached  or  inserted,  while  the  inner  portion  goes 
immediately  over  the  rectus  internus,  capitis  major 
and  longus  colli,  across  the  bodies  of  the  verte- 
brae, extending  under  the  oesophagus,  and  is  con- 
tinuous with  the  corresponding  layer  of  the  oppo- 
site side. 

The  formation  of  the  sheath  for  the  great  ves- 
sels of  the  neck  now  remains  to  be  described,  and 
may  be  easily  understood,  when  it  is  recollected 
how  the  layers  of  the  fascia  are  disposed.  A co- 
vering is  formed  over  the  jugular  vein  by  the  fas- 
cia, where  it  is  passing  under  the  mastoideus. 
Then  another  slip  passing  from  the  anterior  to  the 
posterior  division  of  the  fascia,  runs  below  the  vein, 
and  separates  the  jugular  from  the  artery  and  par 
vagum,  and  the  lower  portion  is  formed  by  a con- 
tinuation of  the  fascia  under  the  carotid  artery. 
From  the  centre  of  this  lower  part  of  the  sheath, 
the  double  perpendicular  process  descends. 

To  demonstrate  this  most  satisfactorily  and  ea- 
sily, make  an  incision  through  the  fascia  under 
the  mastoideus,  in  the  course  of  the  internal  jugular 


32 


ANATOMICAL  INVESTIGATIONS. 


vein — ^raising  this  covering  of  the  vein,  we  should 
then  take  an  inch  or  two  of  the  vein  from  its  bed, 
without  wounding  the  parts  below,  and  we  shall 
see  the  slip  of  fascia  separating  the  vein  from  the 
artery  and  par  vagum.  In  like  manner,  if  we  cut 
through  this  partition  and  carefully  raise  the  ar- 
tery, removing  an  inch  or  two  of  the  vessel,  we 
then  perceive  the  lower  part  of  the  sheath  lying 
immediately  under  the  par  vagum  and  artery.  By 
breaking  through  the  lower  part  of  the  sheath,  we 
may  separate  the  layers  of  the  perpendicular,  or 
fifth  and  sixth  processes. 


ANATOMICAL  INVESTIGATIONS. 


33 


SECTION  III. 

Formation  of  the  Pericardium  from  the  Fascia 
Superficialis. 

The  layer  of  the  fascia  superficialis,  imme- 
diately covering  the  thyroid  gland,  described  as 
the  fifth  process  [p.  31.]  passes  under  the  sternum 
to  the  surface  of  the  arteria  innominata  where  it  is 
joined  by  the  outermost  layer  of  this  fascia,  co- 
vering the  lateral  and  back  parts  of  the  neck.  To- 
gether they  form  a covering  for  the  artery  as  it  is 
passing  between  the  scalenus  anticus  and  medi- 
us. — Over  the  subclavian  artery,  from  its  inferior 
edge,  the  fascia  extends  outwards  and  downwards, 
running  immediately  below  the  subclavius  muscle. 
Near  the  external  edge  of  this  muscle,  we  find  the 
fascia  superficialis  continuous  with  that  portion  of 
the  brachial  fascia,  which  extends  to  the  thorax 
under  the  pectoralis  major. 

We  now  cut  away  the  cartilages  of  the  four 
upper  ribs  on  each  side,  and  remove  the  sternum 

E 


34 


ANATOMICAL  INVESTIGATIONS. 


from  the  clavicles,  having  divided  this  bone  trans- 
versely below  the  fourth  rib.  We  are  thus  ena- 
bled to  separate  the  upper  part  of  the  mediastinum 
and  bag  of  the  pleura  from  the  pericardium.  We 
then  trace  the  fifth  process  or  thyroid  layer,  (in 
union  with  the  outer  part,)  of  the  fascia  superfi- 
cialis  down  to  that  part  of  the  arch  of  the  aorta, 
where  the  serous  membrane  of  the  pericardium  is 
reflected  to  form  the  immediate  covering  of  the 
heart.  Then  we  clearly  perceive,  that  the  Peri- 
cardium is  formed  from  the  Fascia  SuperjicialiSf 
which  is  uninterrupted  and  entirely  continuous  with 
the  capsule  of  the  heart.  The  serous  membrane 
being  cut  through,  we  can  raise  the  fascia  from  the 
surface  of  the  aorta,  down  to  the  commencement  of 
the  fleshy  fibres  of  the  heart,  with  as  much  ease  as 
we  can  elevate  the  outer  or  floating  portion. 

However,  singular  it  may  appear  that  this  ar- 
rangement should  not  have  been  discovered  until 
this  time,  it  is  by  no  means  as  singular,  as  that 
anatomists  during  so  long  a time  should  have  re- 
mained contented  to  believe  that  a serous  mem- 
brane like  the  pleura,  could  form  a strong  fi- 
brous membrane  like  the  pericardium  ! 

If  the  descriptions  here  given  appear  difficult  to 
those  who  have  studied  anatomy  in  the  usual  mode, 
we  are  sure  that  their  surprise  could  only  be  equal- 


ANATOMICAL  INVESTIGATIONS. 


35 


led  by  their  pleasure  on  witnessing  the  facility 
with  which  all  these  arrangements  may  be  demon- 
strated and  the  beautiful  simplicity  of  these  struc- 
tures incontestibly  established. 


36 


‘INATOMTO  AT.  INVKSTKi  ATIONS. 


SECTION  IV. 

Jlrrangement  of  the  Brachial  Fascia  and  formation 

of  the  Capsular  ligament  of  the  shoulder  joint. 

When  we  have  removed  the  integuments  and 
superficial  fascia  from  the  muscles  of  the  shoulder 
and  arm,  we  find  a strong  fibrous  membrane  co- 
vering the  biceps,  which  has  been  hitherto  consi- 
dered as  the  peculiar  fascia  of  that  muscle.  If  we 
cut  through  this  fascia  directly  over  the  centre  of 
the  biceps,  in  its  length,  and  raise  the  portions  to- 
wards the  outside  and  inside  of  the  arm,  we  per- 
ceive that  this  muscle  is  enclosed  in  a sheath  very 
analogous  to  that  formed  for  the  sterno  mastoideus 
in  the  neck,  and  the  sartorius  on  the  thigh.  There 
is  this  difference,  however,  the  fascia  is.  not  simply 
continuous  beneath  the  muscle,  but  the  outer  and 
inner  portions  run  towards  each  other,  under  the 
muscle  and  in  the  centre  both  portions  penetrate 
its  substance,  where  the  two  distinct  heads  may  be 
said  to  cease  and  the  single  fleshy  belly  to  begin. 
On  the  outer  edge  of  the  biceps,  along  the  line  of 
the  humerus,  we  find  the  fascia  attached  to  the 


ANATOMICAL  INVESTIGATIONS.  3T 

bone,  and  where  this  attachment  is  cut  through,  we 
then  see  that  it  is  continuous  over  the  whole  of  the 
triceps,  where  its  strength  is  increased. 

Returning  to  the  opening  made  over  the  centre  of 
the  biceps  we  may  pass  a knife  handle  under  it,  on 
the  short  head  of  the  biceps,  towards  the  scapula. 
This  will  lead  us  to  remark,  the  manner  in  which 
this  fascia  as  it  passes  along  under  the  edge  of  the 
deltoid  muscle  is  attached  thereto,  and  also  sends  a 
delicate  portion  over  the  edge  of  the  pectoralis 
major.  But  on  raising  the  pectoralis  major  with- 
out removing  the  instrument  passed  under  the  fas- 
cia, we  shall  find  the  main  sheet  of  fascia  passing 
to  the  thorax,  covering  the  pectoralis  minor,  going 
under  the  subclavius  and  clavicle  into  the  neck, 
where  it  is  continuous,  with  the  fascia  superficialis 
as  before -mentioned.  If  we  have  pressed  the  knife 
handle  upwards  directly  in  the  course  of  the  short 
head  of  the  biceps,  we  find  the  instrument  reaching 
to  the  coracoid  process,  and  by  cutting  the  fascia 
open,  thus  far  we  see  it  continuing  to  the  edge  of 
the  glenoid  cavity,  forming  all  of  the  fibrous  part 
of  the  capsule  of  the  shoulder  joint. 

To  render  the  demonstration  still  more  conclu- 
sive, cut  through  the  deltoid  muscle  transversely 
immediately  over  the  shoulder  joint,  being  careful 
not  to  injure  the  subjacent  fascia.  Having  cleared 
away  the  deltoid  from  about  the  joint,  we  return  to 


38  ANATOMICAL  INVESTIGATIONS. 

the  outer  portion  of  the  fascia,  where  it  covers  the 
biceps.  There  we  find  the  fascia  continuing  over 
the  inside  of  the  arm  to  the  triceps  as  before  stated, 
and  dissecting  up  this  stronger  portion,  we  shall 
be  surprised  and  pleased  to  see  how  distinctly  it 
runs  up  to  the  edge  of  the  glenoid  cavity  and  under 
the  scapular  portion  of  the  deltoid,  forming  the 
whole  of  the  capsular  ligament.  When  the  fascia 
is  laid  open,  we  have  a beautiful  view  of  the  re- 
flection of  the  synovial  membrane  and  are  tho- 
roughly satisfied  that  there  is  no  distinct  or  inde- 
pendent capsular  ligament,  but  that  this  fascia 
forms  the  whole  of  what  has  been  hitherto  so  cal- 
led. 

The  fascia  is  attached  strongly  to  the  neck  and 
inferior  costa  of  the  scapula  at  the  upper  part,  but 
when  this  attachment  is  cut  through  we  find  the 
fascia  forms  a continuous  sheet  with  the  strong 
covering  of  the  infra  spinatus  muscle. 

The  sheath  for  the  brachial  vessels  is  formed  in 
a manner  analogous  to  the  formation  of  the  cervical 
and  femoral  sheaths,  that  is  by  slips  of  the  brachial 
fascia  passing  over  the  surface,  between  and  below 
the  vessels  and  nerves. 

Kesuming  our  examination  of  the  brachial  fas- 
cia, towards  the  elbow  we  find  it  continuing  over 
the  bend  of  the  arm,  receiving  a considerable 
thickening  from  the  lower  extremity  of  the  biceps 


ANATOMICA'L  INVESTIGATIONS. 


39 


and  then  being  laid  over  the  whole  of  the  fore-arm 
forming  distinct  sheaths  for  the  muscles,  through- 
out analogous  to  the  arrangement  of  the  fascia 
lata.  On  the  outside  of  the  arm  the  attachments  of 
the  brachial  fascia  to  the  radius  and  ulna  are 
strong,  and  the  texture  of  the  whole  of  the  portion 
on  the  back  of  the  forearm  becomes  much  more 
dense,  as  it  is  employed  in  forming  distinct 
sheaths  for  the  muscles  in  precisely  the  same  way 
as  on  the  inside  of  the  fore-arm. 


40 


ANATOMICAL  INVESTIGATIONS, 


SECTION  V. 

Arrangement  of  the  Fascia  Lata. 

In  examining  this  fascia,  after  having  studied 
the  arrangement  of  the  fascia  of  the  neck,  the  ob- 
server will  be  surprised  and  delighted  to  find  that 
there  is  a most  striking  similarity  existing  between 
them,  not  only  in  the  manner  in  which  they  relate 
to  the  muscles,  but  in  the  formation  of  the  sheath  of 
the  vessels. 

To  begin  this  examination,  we  remove  the  in- 
tegument and  fascia  superficialis  from  the  pos- 
terior part  of  the  nates,  and  are  enabled  to  see  how 
far  the  fascia  lata  extends  on  the  ilium  from  the 
part  which  may  be  properly  considered  as  its  ori- 
gin ; being  all  the  edge  of  the  ilium  not  occupied  by 
the  origin  of  the  glutseus  maximus,  out  to  that  por- 
tion of  the  border  of  the  ilium  giving  origin  to  the 
tensor  vaginae  femoris,  immediately  behind  the  an- 
terior superior  spinous  process.  The  tensor  va- 
ginae is  fairly  enclosed  between  two  layers  of  the 
fascia  lata,  which  joining  at  the  interior  and  infe- 
rior parts  of  the  muscle,  form  that  strongest  part  of 


ANATOMICAL  INVESTIGATIONS.  41 

the  fascia  denominated  the  iliac  portion,  or  part 
covering  the  haunch. 

This  iliac  portion  advances  very  little  at  the  up- 
per part,  before  it  again  separates  into  two  layers, 
the  one  going  over  the  sartorius  muscle,  and  the 
other  under  it.  The  superior  layer  is  thinner  than 
the  common  fascia,  and  allows  us  to  see  the  mus- 
cular fibre  through  it — while  the  fibres  of  the  mus- 
cle on  the  outer  part  of  the  thigh,  are  entirely 
hidden  by  the  thickness  and  opacity  of  the  fascia. 
In  consequence  of  the  separation  mentioned,  a 
beautiful  sheath  is  formed  for  the  sartorius,  resem- 
bling in  every  particular  that  formed  by  the  super- 
ficial fascia  in  the  neck  for  the  sterno-cleido-mas- 
toideus. 

If  we  cut  through  the  layer  covering  the  sarto- 
rius, in  the  direction  of  the  muscular  fibre,  a short 
distance  from  its  outer  edge,  and  then  raise  this 
external  portion  towards  the  ligament  of  Poupart, 
we  find  that  it  reunites  with  the  inferior  layer  just 
beyond  the  internal  edge  of  the  tensor.  Let  us 
now  cut  for  the  tenth  of  an  inch  through  this  union 
and  we  shall  see  the  fascia  again  separating  into 
two  layers,  having  a considerable  interspace,  which 
in  many  subjects  contains  an  appreciable  quantity 
of  fatty  matter.  This  part  of  the  fascia  is  situated 
anterior  to  the  upper  part  of  the  sartorius,  and 
would  be  contained  in  a triangle  made  by  drawing 

F 


42  ANATOMICAL  INVESTIGATIONS. 

a line  from  the  middle  of  the  symphysis  pubis  to 
the  sartorius,  having  the  ligament  of  Poupart  for 
the  opposite  side  of  the  triangle,  and  the  muscle 
for  its  base.  Having  made  the  opening  required, 
we  may  then  push  the  handle  of  the  knife  up  to  the 
lower  border  of  Poupart^s  ligament,  below  the  an- 
terior superior  spine  of  the  ilium,  and  by  continuing 
the  pressure  downward  and  inward,  we  may  carry 
the  instrument  entirely  to  the  extremity  of  that  du- 
plicature  which  is  called  the  falciform  process ^ 
semilunar  process,  or  Hey’s  ligament,  without 
using  any  violence.  By  this  last  view  we  are  made 
acquainted  with  the  manner  in  which  the  pubic 
portion  comes  up  under  the  vessels  to  join  the  parts 
described. 

Were  our  examinations  to  cease  here,  they  would 
be  of  comparatively  little  value,  however  interest- 
ing the  research  might  prove  to  the  individual. 
But  1 flatter  myself  that  the  discovery  of  the  pecu- 
liar arrangements  of  this  fasciae,  will  lead  us  at 
once  to  a better  acquaintance  with  its  physiology. 
The  outer  layer,  or  that  part  which  may  be  consi- 
dered as  the  continuation  of  the  external  part  of  the 
sheath  of  the  sartorius,  is  continuous  with  the  ten- 
don of  the  external  oblique  muscle,  which  is  thus 
enabled  to  act  very  advantageously  on  the  fascia. 
The  fascia  lata  is  provided  with  a muscle  whose 
peculiar  business  is  to  tighten  this  great  sheath  of 


ANATOMICAL  INVESTIGATIONS.  4^ 

ihe  thigh ; as  the  tensor  vaginae  femoris  is  situated 
nearly  in  a line  with  the  external  condyle  of  the 
femur,  >yhich  is  by  no  means  so  low,  or  rather  so 
long  as  the  internal,  of  necessity,  in  tightening  the 
outer  part  of  the  fascia  to  the  greatest  degree,  it 
must  relax  the  inner  portion  (covering  the  gracilis, 
adductors,  &c.)  at  the  upper  and  inner  part  of  the 
thigh,  which  is  by  no  means  within  its  sphere  of  ac- 
tion. The  arrangement  mentioned,  the  continnity 
(of  the  external  layer  of  the  iliac  portion)  of  the 
fascia  lata  with  the  tendon  of  the  external  oblique, 
compensates  for  the  defect  that  would  otherwise 
exist,  and  tightens  the  part  of  the  fascia  lata  co- 
vering the  upper  and  inner  part  of  the  thigh.  In 
saying  that  the  fascia  is  continuous  with  the  tendon 
of  the  external  oblique,  we  do  not  say  that  no  con- 
nexion exists  between  the  internal  and  external 
layers,  just  where  the  outer  one  joins  the  tendon  of 
the  oblique.  But  this  union  is  effected  by  a very 
delicate  portion,  not  much  more  than  perceptible,’ 
while  the  junction  between  the  outer  layer  of  the 
fascia,  the  continuity  with  this  tendon,  is  fair 
and  strong,  perfectly  visible  and  palpable.  To 
prove  how  thoroughly  this  arrangement  serves  the 
the  purpose  mentioned,  it  is  only  necessary  to  make 
a slight  pressure  on  the  external  oblique,  or  to  pull 
its  tendon  with  the  forceps  when  the  subject  is 


44  ANATOMICAL  INVESTIGATIONS. 

placed  oil  its  back,  and  the  integuments  and  fascia 
superficialis  are  removed.  We  shall  then  be  con- 
vinced that  a very  slight  contraction  of  the  muscle 
is  capable  of  affecting  the  state  of  tension  of  the  fas- 
cia lata  on  the  inner  part  of  the  thigh. 

The  arrangement  of  the  internal  layer  forming 
the  under  part  of  the  sheath  for  the  sartorius  is  very 
interesting,  and  in  relation  to  the  formation  of  the 
sheath  for  the  vessels,  precisely  similar  to  that  of 
the  third  layer  of  the  superficial  fascia  in  the  neck. 
At  the  outer  edge  of  the  sartorius  the  fascia  splits, 
to  send  one  portion  outwards  and  backwards  over 
the  surface  of  the  muscles,  white  the  inner  portion 
doubling  inwards  and  forwards,  runs  under  the 
sartorius  muscle.  It  may  be  considered  as  the 
continuation  of  the  external  layer — and  after  thus 
forming  the  sheath  of  the  sartorius,  it  runs  onward 
to  cover  the  great  artery  of  the  thigh,  just  at  the 
inner  or  pubic  side  of  which,  the  iliac  and  pubic 
portions  of  the  fascia  are  united. 

We  may  now  with  great  facility  raise  the  layer 
going  over  the  artery.  Then  we  may  raise  any 
portion  of  the  artery  from  its  bed,  leaving  the  pro- 
cess between  the  artery  and  vein — after  this  we  can 
raise  this  portion,  cut  and  lift  up  a part  of  the  fe- 
moral vein,  and  show  the  lower  part  of  the  sheath 
strong  and  fair,  going  beneath  it.  From  the  lower 


ANATOMICAL  INVESTIGATIONS. 


45 


part  of  the  sheath,  we  find  a single  perpendicular 
process  going  down  to  be  fixed  into  the  linea  as- 
pera. 

The  fascia  lata  forms  all  the  sheaths  for  the  mus- 
cles of  the  thigh,  and  continues  to  form  the  sheath 
of  the  vessels  after  the  artery  has  passed  through 
the  tendon  of  the  triceps.  The  pubic  portion  near 
the  ligament  of  Poupart,  passes  under  the  great 
vessels,  and  is  connected  or  rather  continuous  with 
the  fascia  transversalis  or  interna.  This  part 
of  the  investigation  must  be  left  until  we  give  a 
description  of  the  researches  made  relative  to  the 
internal  fascia. 

However  difficult  the  study  of  the  fascia  lata  may 
appear  from  the  description,  it  is  by  no  means  so 
difficult  to  comprehend  when  it  is  examined  with 
the  knife.  When  studied  in  the  manner  here  di- 
rected, the  satisfaction  derived  from  the  clearer 
understanding  of  the  physiology  of  all  the  neigh- 
bouring parts,  will  more  then  compensate  for  the 
difficulties  surmounted  by  the  application  necessary 
to  see  all  that  is  described.  The  important  infiu- 
ence  exercised  by  the  processes  of  this  fascia  (form- 
ing sheaths  for  the  vessels  and  muscles)  over  va- 
rious surgical  diseases  and  operations,  can  only  be 
perceived  by  one  who  is  thoroughly  acquainted 
with  its  true  character,  extent  and  connexions. 
The  establishment  of  the  fact  that  there  is  but  one 


46 


ANATOMICAL  INVESTICATIONS. 


fascia  forming  all  the  processes  about  the  neck,  and 
another  all  those  of  the  thigh,  and  that  in  both  the 
sheath  for  a particular  muscle  as  well  as  the  sheath 
for  the  great  vessels  are  formed  in  the  same  man- 
ner, is  a circumstance  of  very  interesting  character 
and  may  lead  us  still  farther  in  our  researches 
concerning  the  various  parts  they  surround  or  se- 
parate. 


ANATOMICAL  INVESTIGATIONS. 


47 


SECTION  VL 

Arrangement  of  the  Fascia  Interna  Abdominis,  and 
formation  of  the  capsular  ligament  of  the  Hip 
Joint,  from  the  Fascia  Lata. 

The  fascia  which  is  at  present  to  be  described 
has  hitherto  only  been  examined  at  particular  points 
and  under  different  names,  in  consequence  of  which 
much  confusion  has  been  produced  and  the  diffi- 
culties of  acquiring  an  accurate  knowledge  of  its 
relations  needlessly  augmented.  The  fascia  trans- 
versalis,  fascia  iliaca,  fascia  prostrata,  fascia  pel- 
vica,  are  all  parts  of  the  same  fascia,  which  bears 
a sufficiently  close  resemblance  to  the  fascia  super- 
ficialis  in  the  manner  of  its  application  to  the  whole 
of  the  cavity  of  the  abdomen  and  pelvis,  to  justify 
us  in  bestowing  on  it  the  name  of  fascia  interna 
ABDOMINIS,  in  contra- distinction. 

The  FASCIA  INTERNA,  lies  between  the  inner 
surface  of  the  abdominal  muscles  and  peritoneum. 
To  examine  it  most  satisfactorily,  after  having  re- 
moved the  external  portion  of  the  sheath  of  the 
rectus  below  the  navel,  and  raised  this  muscle  from 


48 


anatomical  investigations. 


its  bed,  make  an  incision  from  the  umbilicus  to 
the  anteriour  superiour  spinous  process  of  the 
ilium,  through  the  abdominal  muscles.  This  cut 
brings  us  down  to  the  strongest  part  of  the  fascia 
interna.  We  then  clear  off  the  abdominal  muscles 
without  wounding  the  fascia  so  as  to  expose  all  the 
iliac  and  hypochondric  regions,  and  to  the  edge  of 
the  sheath  of  the  rectus  near  the  median  line  of 
the  body.  If  we  make  a small  hole  through  the 
fascia  interna,  midway  between  the  spine  of  the 
ilium  and  umbilicus,  we  may  introduce  a knife  han- 
dle between  this  fascia  and  the  peritoneum  and  se- 
parate them  from  each  other  throughout  the  lateral 
and  back  parts  of  the  abdomen,  till  we  have  passed, 
over  the  liver  to  the  under  surface  of  the  diaphragm. 
Having  thus  raised  the  fascia  interna,  we  may  by 
blowing  into  the  opening  inflate  the  sac  and  exhibit 
it  fairly  detached  from  the  peritoneum.  Making 
an  incision  through  the  fascia  in  the  same  direc- 
tion as  the  first  cut  through  the  muscles  and  cutting 
from  the  crest  of  the  ilium  to  the  last  rib,  we  turn 
this  upper  flap  over  and  follow  it  towards  the  cen- 
tre, under  the  inner  portion  of  the  sheath  of  the 
rectus.  Here  we  find  it  more  closely  attached  than 
at  any  other  part  both  to  the  tendon  of  the  trans- 
versalis  and  the  peritoneum,  yet  by  careful  dissec- 
tion it  may  be  fairly  separated  from  both,  without 
wounding  either,  so  as  to  show  its  continuity  en- 


ANATOMICAL  INVESTIGATIONS, 


49 


tirely  across  the  anterior  part  of  the  inner  surface 
of  the  abdominal  muscles. 

The  fascia  interna  is  attached  with  firmness  to 
the  whole  of  the  crest  of  the  ilium  from  the  anterior 
superior  spinous  process  backwards ; it  also  is  fixed 
to  the  transverse  processes  of  the  loins,  where  it 
forms  the  covering  of  the  quadratus  lumborum,  and 
also  separates  this  muscle  from  the  external  mus- 
cles of  the  back. 

Returning  to  the  lower  portion  of  the  fascia  in- 
terna we  raise  it  from  the  anterior  superior  spine  of 
the  ilium  to  the  pubis,  and  in  doing  this  we  have  a 
beautiful  view  of  the  internal  abdominal  ring,  the 
space  by  which  the  spermatic  cord  goes  through 
this  fascia  to  emerge  on  the  pubis  after  passing 
through  the  tendon  of  the  external  oblique  or  ex- 
ternal abdominal  ring.  This  is  the  portion  of  the 
fascia  interna,  heretofore  called  fascia  transvevsdlis, 
and  whose  real  character  is  of  so  much  importance 
to  the  surgical  practitioner.  This  part  of  the  fas- 
cia interna  fills  the  vacancy  that  would  otherwise 
exist  between  the  inferior  edges  of  the  internal  ob- 
lique and  transverse  muscles  and  the  edge  of  the 
pelvis,  and  was  called  fascia  transversalis  because 
it  was  thought  to  be  continuous  with  the  transverse 
muscle. 

Below  the  internal  abdominal  ring  the  fascia  in- 
terna touches  the  ligament  of  Poupart  to  which 


50  ANATOMICAL  IN VESTIGATION  S% 

it  is  attached,  but  it  does  not  cease  there,  being; 
continued  down  on  the  great  vessels  of  the  thigh. 
It  is  usually  stated  that  the  fascia  interna  is  here 
so  arranged  as  to  descend  in  the  form  of  a funnel 
for  a certain  distance  before  and  behind  the  great 
vessels  ; to  be  reflected  at  the  distance  of  three- 
fourths  of  an  inch  below  Poupart’s  ligament  and 
thus  to  prevent  any  communication  between  the 
pelvis  and  top  of  the  thigh.  This  is  very  far  from 
the  true  state  of  the  fact ; the  fascia  interna  is 
indubitably  continuous  with  the  fascia  lata  femoris, 
both  on  the  superior  and  inferior  surface  of  the 
great  vessels,  concerning  the  sheath  for  which  we 
have  spoken  in  a preceding  section,  and  the  com- 
munication is  prevented  by  cellular  attachments. 
To  be  convinced  of  this,  let  us  return  to  the  crest 
of  the  ilium,  and  cut  through  the  attachment  of  the 
fascia  interna  to  the  bone.  We  find  this  attachment 
to  be  a short  perpendicular  process,  which  when 
cut  through  leaves  the  continuity  of  the  fascia  in- 
terna and  the  covering  of  the  internal  iliac  muscle 
uninterrupted.  This  last  portion  is  what  has  been 
heretofore  named  the  iliac  fascia.  We  raise  the 
fascia  interna  from  over  the  iliac  muscle  towards 
the  edge  of  the  psoas  magnus,  where  it  separates 
so  as  to  form  a sheath  for  this  muscle  and  after- 
wards goes  to  the  common  iliac  artery,  below,  and 
directly  in  a line  with  which  the  fascia  interna  is 


ANATOMICAL  INVESTIGATIONS.  01 

attached  to  the  linea  ileo  pectinea  and  to  the  bodies 
of  the  lumbar  vertebrae. 

Now  cut  up  the  pubic  extremity  of  Poupart’s 
ligament  and  reflect  it  carefully  towards  the  ante- 
rior superior  spine.  Then  follow  the  iliac  portion 
of  the  fascia  interna  downwards  till  it  passes  under 
the  vessels  and  together  with  the  superior  portion 
forms  the  funnel  shaped  process  of  Professor 
CoLLES.^  We  now  find  this  lower  or  iliac  part  of 
the  internal  fascia  is  perfectly  continuous  with  the 
fascia  lata,  and  we  may  be  still  more  clearly  satis- 
fied of  this,  by  cutting  across  and  removing  about 
an  inch  or  so  of  the  femoral  artery,  which  exhibits 
this  continuity  without  turning  the  fascia  interna 
from  its  place.  The  cellular  attachments  which 
prevent  the  communications  between  the  pelvis  and 
top  of  the  thigh  are  also  now  made  evident. 

From  the  pubic  extremity  of  Poupart^s  ligament 
we  find  the  fascia  interna  passing  into  the  pelvis 
where  we  shall  presently  find  it  forming  the  ante- 
rior ligaments  of  the  bladder  and  triangular  liga- 
ment of  the  urethra,  while  a process  which  goes 
down  over  the  levator  ani  and  obturator  internus, 
forms  the  fascia  of  the  prostrate  gland. 

But  the  most  interesting  and  surprising  part  of 
the  arrangement  of  these  fasciae  is  the  manner  in 


* See  his  excellent  treatise  on  Surgical  Anatomy. 


52 


ANATOMICAL.  INVESTIGATIONS. 


which  the  great  capsular  ligament  of  the  thigh 
bone,  is  formed  from  i\iQ  fascia  lata  femoris,  which 
we  could  not  well  explain  until  the  fascia  interna 
had  been  described.  If  we  trace  the  fascia  lata 
upwards  from  between  the  vastus  externus  and  glu- 
teus maximus,  we  follow  it  over  the  great  tro- 
chanter, and  see  it  extending  over  the  edges  of 
the  glutaeus  medius  and  minimus.  This  will  give 
us  the  external  layer  of  the  outer  part  of  the  cap- 
sule. If  we  cut  up  the  head  of  the  rectus  femoris 
(from  the  anterior  inferior  spiuous  process)  we  shall 
find  the  lower  part  of  its  sheath  forming  the  outer 
layer  of  the  anterior  part  of  the  capsule.  Raising 
this  portion,  and  then  cutting  through  the  lower 
part  of  the  sheath  of  the  femoral  vessels,  (so  as  to 
get  between  the  parts  going  towards  the  inner  and 
outer  parts  of  the  thigh,)  we  raise  the  outer  portion 
to  the  capsule  so  as  to  show  how  it  forms  the  mid- 
dle part  of  its  thickness.  If  we  now  return  to  the 
pubis  and  cut  through  the  pubic  portion  of  the  fas- 
cia down  to  the  bone,  we  raise  this  part,  (which  is 
continuous  with  the  fascia  interna,)  towards  the 
joint,  and  thus  uncover  the  anterior  part  of  the 
joint,  with  the  exception  of  the  delicate  synovial 
membrane.  Thus  we  are  satisfied  that  this  power- 
ful capsule  derives  all  its  strength  from  the  succes- 
sive additions  of  the  fascia  lata,  and  has  no  exist- 
ence as  a separate  or  independent  ligament. 


ANATOMICAL  INVESTIGATIONS. 


53 


SECTION  vn. 

Irregularities  of  Structure, 

Departures  from  the  ordinary  structure  in  the 
human  body  are  much  more  numerous  and  frequent 
than  is  generally  imagined.  But  as  few  persons 
are  exclusively  devoted  to  anatomical  research,  the 
opportunities  of  collecting  a sufficient  number  of  ob- 
servations to  lead  to  any  important  general  conclu- 
sion are  rare,  and  the  facts  are  seldom  recorded, 
because  they  are  observed  at  distant  periods  and 
excite  but  a temporary  interest. 

If  we  were  now  in  possession  of  a carefully  ob- 
served and  fairly  written  statement  of  all  the  aber- 
rations which  have  been  examined  since  anatomy 
has  been  correctly  studied,  we  should  doubtless  be 
enabled  to  draw  some  general  conclusion  of  practical 
utility,  no  less  than  to  explain  many  pathological 
circumstances  which  still  continue  to  be  mysterious. 
Previous  to  the  systematic  essay  of  Dr.  Duncan  on 
the  malformations  of  the  urinary  and  genital  organs, 
published  in  the  Edinburgh  Journal  it  was  sup- 
posed that  each  irregularity  had  an  individual  and 


54 


ANATOMICAL  INVESTIGATIONS. 


appropriate  character,  which  made  the  case  merely 
an  object  of  curiosity.  By  an  examination  of  his 
paper  it  will  be  seen  that  a very  striking  similarity 
existed  in  the  cases  he  observed  as  to  the  manner 
in  which  nature*  accommodated  the  system  to  the 
defective  organization.  Almost  all  the  cases  re- 
lated in  the  periodical  papers  since  Dr.  Monro’s 
essay  are  similar  to  some  of  those  he  has  described, 
or  are  species  of  the  same  genera. 

In  order,  therefore,  td  induce  others  to  commu- 
nicate the  results  of  their  experience,  I shall  at- 
tempt to  arrange  the  instances  of  irregularity  which 
I have  witnessed  in  various  parts  of  the  body, 
hoping  that  those  who  are  possessed  of  similar  ob- 
servations will  be  induced  to  contribute  them  for 
the  general  good. 

I. — The  Osseous  System. 

In  tjiis  system,  there  is  seldom  any  irregularity 
of  structure.  All  the  departures  from  the  ordinary 
arrangement  in  the  cases  I have  examined  were  the 
the  results  of  accident  or  constitutional  disease. 
These  accidental  appearances,  or  results  of  morbid 
action  are  very  numerous,  and  to  be  considered  in 
another  place.  ■ 


ANATOMICAL  INVESTIGATIONS. 


56 


II. — The  Muscular  System. 

We  observe  a considerable  number  of  interesting 
and  peculiar  irregularities  in  this  department. 
Some  muscles,  as  the  pyramidales  the  palmaris 
longus,  zygomaticus  minor  and  plantaris  are  fre= 
quently  deficient,  and  the  proper  motions  or  ac- 
tions do  not  appear  to  be  injured  in  consequence. 
It  does  not  often  happen  that  any  attempt  is  made 
by  nature  to  compensate  for  their  absence  ; in  one 
case,  however,  where  the  palmaris  longus  was  de- 
ficient, I found  a considerable  strip  of  muscular 
substance  arising  from  the  annular  ligament,  just 
above  the  wrist,  and  ascending  one  third  of  the  fore- 
arm, to  be  attached  to  the  common  fascia. 

In  one  instance,  instead  of  the  usual  arrange- 
ment, the  muscle  corresponding  to  the  serratus 
major  anticus,  whose  office  is  to  draw  the  base  of 
the  scapula  downwards,  inwards,  and  forwards, 
took  its  origin  by  two  distinct  portions  from  the  la- 
teral conversity  of  the  second,  third,  and  fourth,  and 
from  the  sixth,  seventh,  and  eighth  ribs,  and  these 
portions  v^re  inserted  separately  into  the  inferior 
angle  of  the  scapula,  and  into  the  base,  from  the 
superior  angle  only  to  the  extremity  of  the  spine, 
leaving  an  interspace  of  three  inches. 


56 


ANATOMICAL  INVESTIGATIONS. 


The  biceps  brachii  flexor  in  three  bodies  exami- 
ned about  the  same  time  was  found  to  have  an  ad- 
ditional slip  or  third  head  coming  off  from  the  infe- 
rior third  of  the  os  humeri  along  the  line  extending 
to  the  inner  condyle.  This  slip  was  half  an  inch 
in  breadth,  and  was  inserted  into  the  fascia,  going 
from  the  tendon  of  the  biceps  over  the  flexor  and 
pronator  muscles,  arising  from  the  inner  condyle. 
In  these  three  cases  the  origin  and  insertion  of  this 
slip  was  precisely  similar.  In  a fourth  and  fifth 
case  presented  a few  days  after,  a distinct  and  beauti- 
ful fleshy  belly  arose  about  half  an  inch  above  the  ori- 
gin of  the  brachialis  internus,  fairly  separated  from 
it  and  the  biceps  by  cellular  substance.  This  ex- 
tra portion  continued  distinct  until  near  the  elbow 
joint,  when  it  was  inserted  into  the  under  surface  of 
the  common  tendon  of  the  biceps. 

The  MUSCLE  of  the  THYROID  GLAND,  was 
found  in  the  Philadelphia  anatomical  rooms,  twice 
during  the  winter  and  four  times  during  the  month 
of  March  (1824.)  The  first  instance  was  observed 
by  a member  of  my  class,  Mr.  Alfred  Hartwell,  of 
N.  C.  In  four  of  these  cases  the  muscle  was  on 
the  left  side,  arising  from  the  upper  edge  of  the 
left  lobe,  and  going  up  to  be  inserted  into  the  os 
hyoides  halfway  between  the  base  and  appendix  of 
that  bone.  In  the  other  two  instances  the  muscle 


J.  Drayton  Sc  ■ 


ANATOMICAL  INVESTIGATIONS.  57 

arose  from  the  centre  of  both  lobes,  through  their 
whole  extent,  and  was  inserted  directly  into  the 
centre  of  the  base  of  the  os  hyoides. 

This  singular  muscle  arising  from  a gland  and 
inserted  into  a hone,  was  first  described  by  Soem- 
mering, and  is  said  to  occur  once  in  five  hundred 
subjects.  l)r.  Horner  mentions  in  his  Anatomy, 
that  he  has  not  met  with  it  in  an  experience  of 
many  years.  From  the  results  of  our  observations 
during  the  last  session,  I am  inclined  to  believe 
that  it  occurs  at  least  in  three  cases  out  of  five,  if  it 
is  not  to  be  found  in  every  case.  That  it  may  be 
very  easily  overlooked  when  it  is  confined  to  the 
left  side,  is  not  surprising  when  we  observe  that  it 
runs  almost  directly  in  the  same  course  with  the 
thyrohyoideus,  from  which  it  is  separated  only  by 
very  delicate  cellular  substance,  and  the  portion 
extending  below  the  origin  of  the  muscle  last-men- 
tioned so  nearly  resembles  in  colour  the  ordinary 
appearance  of  the  membrane  covering  the  gland,  or 
the  gland  itself.  Certain  it  is,  that  since  our  atten- 
tion has  been  called  to  the  subject,  this  muscle  has 
been  found  in  every  body  examined  for  the  pur- 
pose. 

The  most  singular  sport  of  nature,  in  the  muscular 
system,  which  has  fallen  under  my  notice,  is  one 
which  occurred  in  a subject  very  carefully  dissected 
by  one  of  my  class,  Mr.  Isaac  Brinckerhoff  of  N.  Y. 

H 


58  A^fATOMICAL  INVESTIGATIONS. 

This  muscle  arose  from  the  fascia  coveriug  the 
latissimus  dorsi  and  teres  major,  just  within  the 
border  of  the  axilla,  and  ascended  to  be  inserted  by 
a beautiful  tendon  into  the  coracoid  process  of  the 
scapula,  between  the  insertion  of  the  pectoralis 
minor  and  the  shorter  head  of  the  biceps.  A deli- 
cate sheet  of  silvery  tendon  extending  from  its  in- 
sertion over  to  the  edge  of  the  biceps.  This  mus- 
cle which  was  about  two  inches  long  crossed  the 
axilla  beneath  the  brachial  plexus,  as  may  be  seen 
in  the  admirably  correct  delineation  of  it  by  Mr. 
Rembrandt  Peale,  (p.  8.)  What  purpose  it  served 
it  is  not  very  easy  to  perceive  ; it  could  have  tight- 
ened the  fascia  over  the  latissimus  and  teres,  but 
this  is  not  very  necessary  as  w'e  never  see  any  in- 
strument particularly  designed  to  produce  such  an 
effect.  It  is  nevertheless  singular,  that  a structure 
so  purely  accidental  should  be  formed  with  such 
perfect  symmetry  and  regularity. 

III. — The  Arterial  System. 

The  irregularities  of  the  arterial  system  have 
been  more  attended  to,  than  those  of  any  other  part 
of  our  structure.  The  most  remarkable  instance  I 
have  met  with  was  in  an  infant  subject  dissected  by 
Mr.  Robert  Yqyung  of  Indiana,  Pa.  The  arteries 
instead  of  going  off  from  the  arch  of  the  aorta  in 


The  Anomalous  Muscle 


J^esmur 


M Jlruycoa 


Ik  & 

■-•■  7'''' ' ' 

1 

ll 

lllfs 

ANATOMICAL  INVESTIGATIONS.  59 

i;he  usual  manner,  came  olf  thus  ; 1st,  the  right  caro- 
tid artery,  2d,  the  left  carotid  artery,  3d,  the  left 
vertebral  artery,  4th,  the  left  subclavian,  5th,  the 
right  subclavian.  The  right  carotid  artery  crossed 
over  the  trachea  to  get  to  the  right  side  of  the 
neck ; the  right  subclavian  arose  from  the  hacTc  part 
of  the  aorta  after  it  had  described  its  curvature, 
running  behind  the  oesophagus  and  trachea  towards 
the  edge  of  the  clavicle.  The  left  vertebral  artery 
not  less  singular  in  its  origin,  began  from  the  arch 
of  the  aorta  just  behind  and  below  the  left  carotid, 
instead  of  being  given  off  by  the  left  subclavian ; 
the  only  instance  I ever  saw  of  such  an  origin  to 
this  vessel,  though  I have  read  of  two  or  three 
cases  somewhat  resembling  it ; this  subject  was  in- 
jected and  the  drawing  was  made  very  carefully ; 
there  were  possibly  some  singularities  in  the  ve- 
nous system,  but  my  attention  was  not  called  to  this 
subject  until  the  rest  of  the  structure  was  removed 
to  exhibit  the  arteries,  (plate  8,  fig.  1,  2.) 

During  this  winter,  (1823-4,)  we  found  three 
instances  in  which  the  arteria  innominata  gave 
off  the  right  and  left  carotids  and  the  right  subcla- 
vian artery.  This  distribution  cannot  be  exceed- 
ingly rare,  since  we  have  found  it  so  often  during 
a single  session,  and  moreover,  in  subjects  injected 
for  the  purpose  of  making  anatomical  preparations 


(H;  ANA  I'OAIIOAL  lA’ VESTRiATION  S. 

alone,  comprising  a very  small  part  of  the  whole 
number  of  subjects  dissected. 

If  the  operation  of  tying  up  the  arteria  inno- 
minata  were  performed  on  a patient,  in  whom  the 
arteries  were  thus  distributed,  what  would  be  the 
immediate  consequence  ? The  whole  amount  of  the 
circulation  would  at  once  be  cut  off  from  the  right 
arm,  from  the  upper  and  central  parts  of  the  right 
side  of  the  thorax,  from  the  w hole  of  the  anterior 
of  the  neck  and  the  parts  about  the  tongue,  tlie 
whole  of  the  face  and  scalp,  and  from  the  whole  of 
the  anterior  part  of  the  brain.  The  only  blood  which 
would  flow  directly  to  the  brain  would  be  by  the 
left  vertebral  artery,  which  as  it  ascends  to  the 
brain  through  the  long  canal  formed  in  the  trans- 
verse processes  of  the  cervical  vertebrae,  could 
scarcely  be  dilated  sufficiently  to  carry  the  whole 
quantity  of  blood  necessary  to  this  organ.  The 
inosculations  of  the  left  ascending  thyroid — of  the 
lower  intercostals,  of  the  epigastric,  with  the  inter- 
nal mammary — and  of  the  dorsal  branches  with  the 
cervical  vessels,  would  form  nearly  the  whole 
chance  of  the  preservation  of  the  arm,  neck  and 
face,  allowing  that  one  vertebral  artery  could  con- 
vey blood  enough  for  the  brain.  The  possibility 
of  this  distribution  should  at  last  make  us  cautious 
of  recommending  this  operation,  without  having 


ANATOMICAL  INVESTIGATIONS. 


61 


most  attentively  examined  all  the  chances  of  its 
failure ; even  though  ever  so  correctly  performed. 

In  one  instance  there  was  found  a singular  com- 
munication existing  hetweeii  the  right  colic  artery 
and  the  hepatic,  a trunk  as  large  as  the  original 
artery  continuing  from  the  one  to  the  other. 

A very  interesting  case  of  high  bifurcation  of  the 
femoral  artery,  was  met  with  during  the  month  of 
March,  in  an  adult  subject,  whose  vessels  were  in- 
jected. What  renders  this  case  more  peculiar  is 
that  we  find  the  same  distribution  on  both  sides, 
the  profunda  femoris  being  given  off  at  a very  short 
distance  below  Poupart’s  ligament,  and  the  circum- 
flexa  externa  arising  as  a large  distinct  trunk  from 
the  femoral,  all  these  branches  lying  immediately 
under  the  fascia  lata.  On  the  left  side  of  this  body, 
the  arteria  obturatoria  was  given  off  by  the  Epi- 
gastric. The  dissection  from  which  Mr.  Lesueur 
made  his  drawing  was  very  carefully  prepared  by 
Messrs.  Price  and  Comstock,  members  of  the  class. 


62 


ANATOMICAL  INVESTIGATIONS. 


SECTION  VIII. 

MORBID  ANATOMY. 

Oseous  System. 

One  of  the  most  singular  appearances  met  with 
during  this  season,  is  the  distorted  pelvis  of  which 
views  are  given  in  plate  5. 

It  seems  to  have  arisen  from  the  dislocation  of 
the  pubic  bones,  by  means  of  which  one  is  made  to 
project  beyond  the  other,  so  as  to  give  a sharp  pro- 
minence both  on  the  outer  and  inside  of  the  pelvis. 
The  degree  in  which  this  displacement  affected  the 
diameters  of  the  pelvis  is  very  accurately  figured 
by  Mr.  Lesueur’s  drawing.  The  right  kidney  lay 
considerably  within  the  ilium  over  the  iliac  muscle. 
The  left  was  not  so  low  but  considerably  lower 
than  ordinary.  The  cartilage  at  the  symphysis  al- 
though so  much  distorted  appeared  to  be  very  little 
different  from  the  natural  condition,  and  no  idea 
could  be  formed  of  the  cause  producing  the  defor- 
mity. The  womb  of  this  subject  was  also  diseased 
as  will  be  hereafter  described. 


I)^a^vll  ic  En^'d  t/y  JJ)TitytO}t . 


t 


ANATOMICAL  INVEST1GATI0>'S.  ' QS 

Plate  6,  gives  a representation  of  a very  interest- 
ing case  of  exostosis,  occurring  in  the  body  of  an 
old  woman  apparently  65  years  of  age.  A part  of 
the  large  mass  near  the  lower  extremity  projected 
through  an  immense  ulcer  of  a very  disagreeable 
appearance.  The  whole  extent  of  these  bones  is 
covered  by  the  sharp  irregular  spines,  which  give 
to  the  fibula  a considerable  resemblance  to  a sta- 
lactite. In  other  respects  this  subject  showed  no- 
thing extraordinary,  nor  had  we  an  opportunity  of 
forming  any  opinion  as  to  the  cause  producing  the 
diseased  appearance  of  the  bones.  It  may  have 
been  owing  to  the  efiTects  of  venereal  taint. 

In  another  instance,  the  lower  part  of  the  femur, 
the  tibia  and  fibula  were  enlarged  and  gibbous 
through  their  whole  extent,  and  in  this  case,  there 
was  suflBcient  reason  to  believe  that  the  immediate 
cause  of  the  evil  was  the  venereal  disease. 

A highly  interesting  result  Avas  obtained  by  exa- 
mining the  body  of  a female  who  had  perished  by 
falling  into  the  fire  during  an  epileptic  fit.  The 
viscera  of  the  chest,  abdomen,  &c.  were  perfectly 
natural.  Within  the  head  a bony  tumor  was  found 
growing  from  the  internal  surface  of  tlie  scull  cap, 
about  half  an  inch  from  the  longitudinal  sinus,  and 
which  encroached  on  the  brain  nearly  half  an  inch. 
On  separating  the  hemisphere  so  as  to  examine  the 
falx  a large  irregular  ossification,  was  found  upwards 


B4  ANATrtM^CAL  INVESTIGAtlONS. 

of  three  fourths  of  an  inch  in  length  projecting  on 
both  sides  so  as  to  press  considerably  on  the  brain. 
In  the  course  of  the  longitudinal  sinus,  several 
spiculsB  very  singular  and  pointed,  presented  their 
cutting  edges  tovrard  the  brain.  A view  of  those 
ossifications  is  given  in  the  plate.  One  side  of 
this  scull  was  much  less  convex  than  the  other,  as 
if  it  had  been  flattened  in  early  life  by  long  con- 
tinued pressure. 

I have  dissected  the  head  of  a black  man  whose 
scull  was  as  well  shaped  as  the  generality  of  per- 
sons of  colour.  He  had  been  lunatic  during  several 
years  previous  to  his  death,  and  on  dissection,  the 
falx  of  the  dura  mater  was  found  to  contain  three 
considerable  patches  of  ossification.  The  mem- 
branes of  the  brain,  showing  evident  appearances 
of  having  been  inflamed  shortly  previous  to  death, 
but  it  was  not  possible  to  determine  whether  the 
ossification  had  been  the  immediate  exciting  cause 
of  the  inflammation. 

Muscular  System. 

The  only  morbid  appearance  observed  in  this 
system,  was  the  change  of  the  gastrocnemius  and 
soleus  of  one  leg,  into  a substance  somewhat  re- 
sembling a mixture  of  ligament  and  cartilage,  hav- 
ing no  trace  throughout  of  proper  muscular  struc- 


■'  ■■  ^^  ■ ■■  ¥(> 


rfyn- 


- ^■■■.'  ' > ■ ' ’ 

' *0' 

' ' )*!*■■- 


■ 'h'.  '■' 


ANATOMICAL  INVESTIGATIONS. 


65 


Cure.  Ill  colour  it  differed  but  little  from  the 
common  appearance  of  the  tendo  achillis,  when  it 
has  been  for  a short  time  exposed  to  the  air. 

Arterial  System. 

The  most  frequent  alteration  observed  in  the  ar- 
teries was  the  deposition  of  bony  matter  in  their 
coats.  This  generally  was  found  in  greatest  quan- 
tity in  the  aorta.  In  one  instance  it  extended  to 
the  arteries  of  the  brain  and  indeed  throughout  the 
body.  But  in  the  brain  all  the  vessels  down  to 
such  as  were  not  much  larger  than  a bristle  or 
horse  hair,  Avere  almost  entirely  bony.^ 

Venous  System. 

The  veins  were  in  many  instances  in  a varicose 
state  especially  in  the  inferior  extremities.  The 
vessels  were  much  more  varicose  when  they  were 
seated  between  the  skin  and  fascia  of  the  leg.  Af- 
ter passing  under  the  fascia,  the  veins  were  seldom 
as  much  diseased  as  where  they  were  not  subjected 
to  this  pressure.  In  two  cases  of  varicose  veins  of 

* In  a case  of  general  or  at  least  very  extensive  ossification  of 
the  capillary  vessels,  how  could  the  circulation  be  continued,  ac- 
cording to  the  notions  of  those  who  think  the  capillaries  possess' 
the  power  of  propelling  their  contents,. independent  of  the  heart? 

I 


66  ■ ANATOMICAL  INVESTIGATIONS. 

the  leg,  encysted  melicerous  tumours  were  found 
near  to  that  part  of  the  adductor  which  is  perforated 
by  the  artery. 

Respiratory  System. 

Many  cases  of  tuberculous  lungs  were  examined 
and  a great  variety  of  appearances  indicative  of 
their  different  states  remarked.  In  several  in- 
stances the  whole  hemisphere  was  found  hepatized 
or  resembling  the  liver  in  texture,  while  only  a 
small  part  of  the  opposite  hemisphere  remained  fit 
for  the  purposes  of  respiration. 

In  one  case  a body  was  examined  which  exter- 
nally exhibited  no  peculiarity,  and  the  whole  body 
seemed  plump  and  fieshy,  on  examining  the  chest, 
on  the  left  side  instead  of  lung  was  found  a large 
irregular  sac,  apparently  made  up  of  the  pericar- 
dium and  pleura  massed  together,  filled  with  a 
bloody  and  offensive  fluid.  There  was  no  pecu- 
liarity in  the  right  lung. 

From  the  appearance  of  the  sac  and  the  state  of 
the  lung  we  should  hardly  suppose  that  the  changes 
could  be  effected  in  a short  time,  yet  the  quan- 
tity of  fat  and  the  general  fulness  of  the  body 
seemed  to  indicate  any  thing  rather  than  long  con- 
tinued disease. 


ANATOMICAL  IN  V ESTIGATfONS. 


67 


Disiestive  System. 

Diseased  appearances  of  the  stomach  were  not 
very  frequent.  Effusions  and  adhesions  were  of- 
ten found  in  different  parts  of  the  belly.  In  some 
cases  there  were  well  marked  evidences  of  general 
inflammation  of  the  bowels.  One  of  these  cases 
was  very  interesting  on  account  of  the  great  ex- 
tent of  the  mischief  produced  in  consequence  of 
the  inflammation. 

The  M'hole  of  the  abdominal  viscera  were  so 
massed  together  as  to  render  it  almost  impossible 
to  separate  the  parts  without  cutting  through  them. 
The  liver  was  uncommonly  enlargetl,  the  left  lobe 
compressing  the  stomach  and  the  right  thrusting  the 
bowels  towards  the  centre  of  the  abdominal  cavity. 
The  convex  surface  of  the  liver  had  elevated  the 
diaphragm  to  the  greatest  degree  it  was  capable  of, 
and  it  was  evident  from  the  slight  effects  produced 
by  very  considerable  pressure,  that  the  motion  of 
the  diaphragm  must  have  been  almost  entirely  sus- 
pended for  some  time  before  death.  Throughout 
the  whole  of  the  ajbdomen,  and  between  the  lamina 
of  the  mediastinum  there  were  tubercles  resembling 
glands  in  appearance,  from  the  size  of  a small  pin’s 
head,  up  to  the  magnitude  of  a large  Walnut.  The 
lungs  were  very  much  compressed,  not  only  by  the 


68  ANATOMICAL  INVESTIGATIONS. 

enlargement  of  the  liver  and  elevation  ot  the  dia- 
phragm hut  hy  the  large  quantity  of  fluid  elfused  in 
the  cavity  of  the  chest  and  pericardium.  The 
brain  also  contained  a considerable  quantity  of 
fluid,  but  gave  no  well  marked  traces  of  inflamma- 
tion. In  such  a case,  it  is  wonderful  that  life 
should  have  been  continued  during  a period  sufli- 
ciently  long  to  allow  these  changes  to  take  place. 
I have  dissected  one  subject,  a mulatto  female, 
about  24  or  25  years  of  age,  ift  wliom  sometliing  of 
a similar  displacement  of  the  thoracic  and  abdomi- 
nal viscera,  had  been  produced  by  tight  lacing. 
The  ribs  and  cartilages  were  so  much  drawn  in 
as  to  give  quite  a conical  appearance  to  the  lower 
part  of  the  chest. 

On  inspecting  the  cavity  of  the  abdomen  tlie  liver, 
stomach  and  spleen,  were  much  elevated  and  the 
diaphragm  so  much  pushed  up  as  to  encroach  con- 
siderably, on  the  lungs.  When  the  upper  part  of 
the  thorax  was  examined,  a very  large  portion  of 
the  apex  of  the  lungs  extended  above  the  clavicles, 
under  the  scaleui,  within  the  triangle  of  the  pleura 
which  under  ordinary  circumstances  is  quite  small. 
It  seemed  as  if  the  system  had  made  an  efibrtto  com- 
pensate for  the  loss  of  space  in  the  thorax  produced 
by  the  encroachment  of  the  abdominal  viscera  on 
its  cavity.  The  impcuiiinent  thus  produced  to  the 
proper  passage  of  the  blood  througli  the  lungs,  the 


ANATOMICAL  INVESTIGATIONS. 


69 


hindrance  of  the  motions  of  the  diaphragm,  and  the 
disturbance  caused  in  the  stomach  and  liver,  must 
convince  every  candid  examiner  of  the  pernicious 
tendency  of  this  preposterous  mode  of  dressing. 

Excretory  System, 

In  an  old  female  subject,  an  appearance  of  pus 
in  the  vagina  led  to  the  scrutiny  of  the  uterus  as 
being  the  probable  seat  of  an  abscess.  But  instead 
of  an  abscess,  there  was  a fistulous  opening  through 
the  posterior  wall  of  the  uterus,  and  this  opening 
was  found  to  be  continuous  with  a long  fistulous 
tube  extending  from  tlie  pelvis  of  the  right  kidney. 
At  the  commencement  of  the  ureter  a calculus  had 
become  so  fixed  as  to  prevent  the  flow  of  urine, 
though  it  did  not  entirely  fill  up  the  ureter.  The 
consequence  had  been  the  ulceration  of  the  pelvis 
of  the  kidney  and  the  eventual  establishment  of  this 
outlet  through  the  vagina.  It  is  not  difficult  to 
suppose  that  a case  of  this  kind  must  have  been 
attended  with  a great  deal  of  distress,  and  it  is  very 
probable  that  all  the  treatment  was  directed  to  the 
uterus.  This  must  have  been  totally  ineffectual 
as  the  cause  was  so  little  connected  ivith  this  organ. 
We  have  no  diagnostic  which  could  enable  us  to 
determine  wdtli  any  thing  like  certainty,  the  true 
seat  of  such  a disease. 


70 


ANATOMICAL  INVESTIGATIONS. 


Genital  System. 

Several  highly  interesting  cases  of  diseased 
womb  were  met  with ; two  of  them  we  have  been 
enabled  to  preserve.  The  first  occurred  in  the 
body  of  a female  whose  distorted  .pelvis  is  figured 
in  plate  5^  and  a sketch  of  the  diseased  womb  is 
given  in  another  plate.  At  first  sight  this  womb 
appeared  to  be  double,  but  on  examination  this  ap- 
pearance was  discovered  to  be  owing  to  two  fieshy 
tumors  growing  from  its  sides,  and  lying  between 
the  layers  of  the  lateral  ligaments,  about  two  inches 
in  length  by  one  in  breadth.  They  had  no  open- 
ings into  their  substance.  Some  small  fleshy  bo- 
dies hung  from  the  internal  surface  into  the  cavity 
of  the  womb,  resembling  polypi  by  their  slender 
necks  and  broad  pendulous  extremities. 

The  other  case,  figured  in  plate  5,  is  a globular 
tumor  growing  out  of  the  posterior  wall  of  the  ute- 
rus, nearly  filling  its  cavity.  Previous  to  mak- 
ing an  incision  through  the  walls,  this  uterus  had 
all  the  external  appearances  of  being  impregnated, 
or  containing  an  ovum,  six  weeks  developed. 

Some  bodies  about  the  size  of  a small  rifle  ball 
were  found  between  the  layers  of  peritoneum  form- 
ing the  broad  ligaments.  Externally  they  were 
quite  smootli,  hard  and  white,  and  when  closely 


#■ 


w.  ,,, 


'■V  ■ 


" %, . i;.r 


; %.’  ■ • { ip  .;; 


*r  ^ , - 


■■  ' ?(=;;  V 


ANATOMICAL  INVESTIGATIONS. 


71 


examined  were  seen  to  be  entirely  composed  of 
bony  matter.  A substance  in  every  respect  simi- 
lar was  found  in  the  neighbourhood  of  the  emul- 
gent  vein  of  the  right  side  in  the  same  subject. 

If  we  recollect  how  small  a proportion  of  the 
bodies  which  annually  die  are  dissected — and  how 
small  the  number  of  those  dissected  are  thoroughly 
examined,  we  need  not  feel  surprised  that  so  many 
irregularities  of  structure  are  presented,  or  that 
anomalies  should  occasionally  be  observed.  Per- 
haps a more  universal  and  careful  examination  of 
the  dead  will  hereafter  convince  us,  that  what  have 
heretofore  been  recorded  as  irregularities,  may 
occur  too  frequently  to  permit  us  even  to  consider 
them  as  exceptions  to  a general  rule.  It  is  much 
to  be  hoped  that  physicians  will  improve  every  op- 
portunity of  making  careful  examinations  by  dis- 
section, and  thus  fix  pathology  on  the  only  basis 
which  can  withstand  the  destructive  infiuence  of 
change  and  time.  In  our  large  cities  very  praise- 
worthy efforts  to  collect  such  knowledge  are  daily 
made,  but  to  be  useful,  the  practice  should  be  uni- 
versally diffused. 


72 


ANATOMICAL  INVESTIGATIONS. 


SECTION  IX. 

THE  HYMEN. 

No  better  proof  can  be  given  of  the  imperfect 
manner  in  which  observations  are  made,  or  the 
precipitancy  with  which  conclusions  have  been 
drawn  concerning  structure,  than  is  exhibited  in 
the  history  of  opinions  relative  to  this  membrane. 
Some  persons  have  found  it  in  almost  every  in- 
stance, others  have  never  been  able  to  see  it — one 
party  has  declared  it  inseparable  from  the  condi- 
tion of  youth  and  virginity — another,  that  it  never 
had  an  existence.  Among  foreign  writers  the  dis- 
cussion has  been  for  a long  time  kept  up,  and  in 
this  country  opinion  is  not  altogether  settled.  A 
paper  was  read  to  the  Medical  Society  of  Phila- 
delphia by  a gentleman  of  large  experience,  during 
the  last  session,  in  which  the  very  existence  of  this 
membrane  was  denied,  and  the  origin  of  the  gen- 
eral opinion  ingeniously  accounted  for.  Three 
days  after  the  reading  of  this  paper  a female  sub- 
ject about  twelve  years  of  age  was  brought  to  the 
rooms.  On  examination,  the  hymen  was  found 


mi 


Tacjt 


ANATOMICAL  INVESTIGATIONS.  73 

very  perfect,  aud  corresponding  in  all  things  to  the 
descriptions  heretofore  given  by  anatomists.  In 
consequence  of  the  doubts  which  had  been  excited 
by  Dr.  Rousseau’s  paper  relative  to  its  existence, 

I had  a drawing  made  of  it  in  its  recent  state  by 
Mr.  0.  A.  Lesueur,  (whose  name  is  synonymous 
with  TRUTH  in  all  that  pertains  to  graphic  delinea- 
tion,) and  the  whole  genital  apparatus  was  care- 
fully preserved  in  spirits  by  Mr.  Leyburn  the  at- 
tentive student  to  whom  the  subject  belonged.^ 
This  was  the  third  instance  in  which  the  hymen 
w.as  found  entire  during  this  session.  The  first 
was  in  the  body  of  a black  girl  between  fourteen 
and  sixteen  years  of  age,  and  the  second  in  the 
body  of  a female  infant  about  three  years  of  age. 
As  the  last  two  cases  occurred  sometime  previous 
to  the  reading  of  the  paper  that  reiterated  the 
doubts  of  the  existence  of  the  hymen,  no  drawing 
was  made,  nor  were  the  parts  preserved. 

Although  there  can  be  no  doubt  of  the  regular  ex- 
istence of  the  hymen,  still  its  existence  is  not  proof 
positive  of  spotless  chastity,  as  women  have  been 
impregnated  without  rupture  of  this  membrane  and 

* The  preparation  made  by  this  young  gentleman  of  the  whole 
subject  is  one  of  the  most  admirable  display,  of  the  arterial  systems 
in  its  minuteness,  that  I have  ever  seen.  The  cabinets  of  Phi- 
ladelphia, New  York,  and  Baltimore,  which  I have  examined  con- 
tain no  preparation  that  can  be  compared  with  this  as  a whole. 

K 


74 


ANATOMICAL  IN VliS'iTGATlONS. 


many  instances  are  recorded  in  which  pregnancy 
was  produced  notwithstanding  the  existence  of  an 
external  malformation,  utterly  forbidding  the  in- 
troduction of  the  male  organ.  This  fact,  unfortu- 
nately for  some  ingenious  theorists  on  generation, 
is  too  well  established,  to  sutfer  their  speculations 
to  he  credited.* 

■*  The  Hymen  (so  named  from  the  Greek  word  a mein- 
brane,)  is  formed  by  four  angular  duplicatures  of  the  membrane  of 
the  vagina, 4he  union  of  which  may  be  discovered  by  corresponding 
lines  on  the  hymen.  At  the  upper  ‘ part  there  is  a semilunar  va- 
cancy, intended  for  the  transmission  of  the  menses,  so  that  it  as- 
sumes the  form  of  a crescent;  a circumctance  which  afifords  the 
true  explanation  of  the  origin  and  meaning  of  the  symbol  so  charac- 
teristically assigned  to  Diana.  In  some  rare  cases,  the  hymen  is 
an  imperforate  circular  membrane,  attached  to  the  edge  of  the 
orifice  of  the  vagina  in  every  part,  so  as  to  close  the  canal  com- 
pletely. The  girls,  in  whom  this  fault  of  confirmation  existed, 
were  called  by  the  Greeks  the  physicians  who  have  written 

in  Latin  amongst  us  have  given  them  the  name  of  Imperforates, 
clauses^  or  velatce;  and  the  Italians  that  of  Coperchiate.  The 
Rotpans  had  no  appropriate  word  to  denote  this  malformation,  and 
they  were  therefore  obliged  to  express  it  by  some  circumlocution: 
it  is  thus  that  Cicero  {De  Divinat.  lib,  ii.)  speaks  of  a dream, 
where  a woman  was  seen  “ quee  obsignatam  habebatnaturamf’  and 
that  Pliny  {Hist.  JVat.  lib.  vii.  c.  16.)  relates,  Cornelia,  the  mother 
of  the  Gracchi,  “ concreti  genitali  nata  fuerat.^’  In  many  cases 
the  membrane  appears  never  to  have  been  formed;  while,  in  others, 
*ts  extreme  tenuity  has  occasioned  its  rupture  and  destruction  in 
early  lifer  it  may,  moreovei*,  have  been  destroyed  by  disease,  by 


ANATOMICAL  INVESTIGATIONS. 


75 


111  additiou  to  what  we  have  demonstrated  rela- 
tive to  the  hymen  in  t|ie  human  female,  it  may  he 
of  advantage  in  ending  all  doubt  on  this  subject,  to 

noxious  habits,  or  by  acrimonious  discharges.  This  extreme  un- 
certainty has  led  many  authors,  of  no  inconsiderable  eminence, 
to  deny  its  existence ; while  others  have  acknowledged  its  occa- 
sional presence,  but  have  attributed  its  formation  to  disease. 
Graaf,  Penius,  Buffon,  Dionis,  declare  that,  by  dissection  of  girls 
of  all  ages,  they  have  never  been  able  to  discover  it;  on  the  other 
hand,  the  reality  of  this  membrane  has  been  maintained  by 
Berenger  de  Carpi  {In  Isagoge  Anatomica,)  Vesalius  (De  Corp. 
Huma.  Fabric,  ^v.  c.  15,)  Fallopius  {In  Observat.  Anatom,.') 
Voleherus  Coiterus  {In  Tabul.  Anatom.,)  Varolius  {Anatom. 
lib.  iv.  c.  4,)  B-iolanus  (Anthropog.  lib.  i.  c.  16,)  Bartholin 
{Anat.  lib.  i.  c.  31,)  Weisus  {Observat.  lib.  i.  et  de  Lamiis  lib. 
iii.  c.  20,)  Spigelius  {De  Hum.  Corp.  Fabrica,)  lib.  viii.  c. 
18,)  Diemerbroeck  {Anatom,  lib.  i.  c.  16,)  Swammerdam  {De 
Uteri  Mulieb.  Fabrica,)  Techmeyer  {Institut.  Medicin.  Legal  et 
Forens.  c.  iv.,)  and  all  the  more  learned  and  able  anatomists  of  the 
sixteenth  and  seventeenth  centuries.  Heister  ( Compend  Anatom. 
and  Ephem.  JVat.  Curios.  Cent.  viii.  Observ.  69,)  Frederick 
Ruysch  {Thes.  Anatom,  iii.  no.  16;  vi.  no.  1;  vii.  no.  60,)  Mor- 
gagni {Adversaria  Anatom,  i.  29;  iv.  23,)  and  Winslow  {Exposit. 
Anatom,  no.  653,)  all  describe  this  membrane,  and  assert  that  they 
have  found  it  in  every  young  girl  they  have  had  occasion  to  examine. 
Astruc  {on  the  Diseases  of  Women,  vol.  i.  p.  123,)  in  referring  to 
the  above  learned  authorities,  observes  that  “ the  inference  must 
necessarily  be,  that  those  who  deny  ever  to  have  seen  it,  must  either 
have  examined  only  such  girls  as  had  lost  their  virginity,  or  prepos- 
sessed with  the  false  notion  that  the  hymen  must  always  close  the 
entrance  to  the  vagina  entirely,  they  have  mistaken  it  at  the  time 


76 


ANATOMICAL  INVESTIGATIONS, 


subjoin  the  following  statement  of  the  existence  of 
this  membrane  in  inferior  aijimals,  from  a work  of 
high  authority  in  natural  liistory. 

This  singular  character  does  not  exclusively 
belong  to  the  female  organs  of  the  human  species. 
It  is  now  ascertained  that  all  female  mammiferse, 
previous  to  copulation  this  sign  of  virginity  present 
in  different  degrees ; and  hence,  it  is  not  as  Hal- 
ler supposed  for  a moral  reason  that  the  mem- 
brane has  been  given  to  women.  A strong  fold  of 
the  lining  membrane  of  the  vagina  has  been  ob- 
served in  female  elephants,  before  they  have  brought 
forth.  Steller  has  made  the  same  observation  on 
the  females  of  the  seal  and  the  lamantin  of  the 

it  was  before  their  eyes,  and  have  even  sometimes  given  the  de- 
scription of  it,  without  mentioning  the  name.”  After  this  literary 
history  of  the  question,  we  may  very  safely  conclude  that  the  hymen 
is  a perfectly  natural  structure,  occurring  in  the  virgin,  and  that  by 
sexual  intercourse  it  is  ruptured;  after  which  it  is  shrivelled  into 
several  small  excrescences  at  the  orifice  of  the  urethra,  called  the 
canmctilce  myHiformes.  But,  since  it  is  liable  to  such  variations 
in  appearance,  and  to  accidental  rupture,  from  the  slightest  causes, 
its  absence  can  never  be  received  as  evidence  of  defloration;  nor 
can  its  presence  be  considered  as  an  unequivocal  proof  of  virginity; 
for  it  has  been  asserted  by  indisputable  authority,  that  it  is  not  al- 
ways ruptured  in  coiiu.  Ruysch  has  said,  that,  if  the  coitus  take 
place  immediately  after  the  menstrual  excretion,  this  membrane  is 
not  IJruptured,  (Observ.  Anuf.  Chiriirg.  xxii.)  See  Lond.  Med, 
and  Phys.  Journal,  p.  211.  vol.  li. 


ANATOMICAL  INVESTIGATIONS.  77 

north,  (rytina.)  Carnivorous  animals  such  as  cats, 
dogs,  the  hyena  and  otter  have  a strictured  circle  or 
hymen  separating  the  vulva,  from  the  vagina  pro- 
per. The  female  bear  and  coati  present  a divided 
membrane, — in  the  daman,  (hyrax  capensis)  it  is  a 
circular  fold.  The  ruminants  and  solipeds,  (such 
as  mares  and  asses)  previous  to  engendering  have 
an  analogous  membrane.  Among  the  apes  and 
monkeys,  the  hymen  consists  of  two  crossing  mem- 
branes placed  on  each  side  of  the  canal  of  the  va- 
gina, their  extremities  being  supported  on  a longi- 
tudinal roll  which  extends  through  the  upper  and 
lower  part  of  the  vagina.  The  same  circumstance 
is  remarked  in  the  American  apes  as  in  the  coaitis, 
marikinas,  wistitis  and  other  sagouins.”  \jJ\Toiiveaii 
Dictionnaire  d’histoire  J^Tatiirelle.  p.  515. 


78 


ANATOMICAL  INVESTIGATIONS. 


SECTION  X. 

VENA  AZYGOS  DORSALIS. 

In  plate  7,  is  given  a very  correct  representation 
of  a vein  not  figured  nor  described  in  any  book  of 
Anatomy  to  which  I have  had  access,  and  for  which 
I have  proposed  the  name  of  azygos  dorsalis  from 
its  peculiar  character. 

This  vein  lies  immediately  under  the  integuments 
of  the  back,  and  emerges  at  a short  distance  above 
the  origin  of  the  trapesius  muscle.  It  ascends 
external  to  the  trepesius  as  a distinct  trunk,  re- 
ceiving branches  from  both  parts  of  the  muscle  un- 
til it  has  risen  as  high  as  between  the  third  and 
fourth  dorsal  vertebrae.  Then  it  separates  into  two 
trunks,  which  diverge  an  inch  or  more  from  the 
spine,  and  penetrate  the  muscle  immediately  above 
the  second  dorsal  vertebra  and  empty  their  blood 
into  the  subclavians  by  means  of  the  deep  seated 
cervical  veins.  The  ordinary  veins  of  the  back 
send  their  blood  more  directly  to  the  heart  by  pour- 
ing it  at  once  into  the  branches  of  the  intercostals 
terminating  in  the  vena  azygos,  interna. 


ANATOiMICAI.  INVESTIGATIONS.  79 

The  drawing  of  this  vein,  made  by  Mr.  W.  B, 
Fahnestock^  a member  of  the  class  gives  a very  aC” 
curate  idea  of  the  situation  and  character  of  this 
vessel. 


80 


ANATOMICAL  INVESTIGATlONa. 


SECTION  XL 

Description  of  the  Table  invented  for  the  Philadel- 
phia Anatomical  Rooms. 

This  beautiful  and  most  excellent  table  was 
devised  by  Mr.  Coleman  Sellers  of  Philadel- 
phia, October  1823;  after  having  seen  how  ina- 
dequate the  common  table  was  for  showing  with 
any  advantage  to  the  class,  almost  all  the  necessary 
views  in  anatomy.  Anatomical  tables  have  hith- 
erto been  made  so  as  to  turn  on  a pivot,  to  allow 
the  subject  to  be  presented  to  every  part  of  the 
room.  When  it  is  necessary  to  elevate  the  whole 
ora  part  of  the  subject  on  the  common  table,  blocks 
of  wood  are  employed,  and  if  it  be  required  to 
change  the  position  during  the  time  of  lecturing  it 
cannot  be  done  without  much  inconvenience. 

Mr.  Sellers^  Anatomical  table  is  six  feet  in 
length  and  is  supported  on  one  strong  column  of 
wood  about  six  inches  in  diameter.  This  upright 
is  bored  to  receive  the  strong  iron  pivot  more  than 
two  feet  long  which  is  fixed  to  the  floor  by  strong 
screws.  The  top  of  the  table  is  formed  of  four 


INVExVTKlJ  i(>]'  tke  PIJlLx\l)ELPHlA 


ANATOMICAL  INVESTIGATIONS. 


8i 


parts,  jointed  in  such  a manner  as  to  allow  their 
positions  to  be  readily  changed.  In  the  centre 
both  sides  are  hinged  to  a strong  transverse  piece 
of  timber,  and  at  six  inches  from  one  end,  and  at 
eighteen  inches  from  the  extremity  at  the  opposite 
end,  there  is  a hinge  which  allows  these  portions  to 
be  raised  to  a level  with  the  general  surface  of  the 
table  or  to  be  depressed  to  any  degree  in  the  quad- 
rant of  the  circle  described  by  folding  it  down  to 
the  extent  permitted  by  the  hinge.  The  larger  and 
smaller  divisions  are  sustained  on  strong  and  ea- 
sily managed  iron  racks,  which  keep  the  part 
raised  in  whatever  portion  it  may  be  left.  The 
smaller  racks  at  the  extremities  are  governed  by  a 
thumb  piece,  which  when  slightly  touched  throws 
the  rack  off  its  rest  and  allows  the  leaf  to  descend. 
To  raise  the  greater  racks  bearing  the  larger  parts 
of  the  table  it  is  only  necessary  to  push  them 
slightly  with  the  foot,  by  which  stooping  is  ren- 
dered unnecessary. 

Besides  the  general  and  partial  elevation,  and 
depression  of  the  extremities,  this  table  may  be 
elevated  or  depressed  laterally  to  any  useful  de- 
gree. 'This  is  effected  by  a broad  and  strong  joint 
formed  in  the  lower  part  of  the  transverse  piece  of 
timber  to  which  the  extremities  of  the  table  are 
hinged.  The  table  is  kept  at  any  degree  of  lateral 
elevation  or  depression  by  a very  beautiful  and 


82 


AKATOMICAL  INVESTIGATIONS. 


simple  mechanism.  A small  piece  of  mahogany 
is  hinged  to  the  side  of  the  table,  and  at  the 
angle  it  forms  with  the  supporting  column,  the 
lower  part  being  mortised  to  the  proper  distance 
to  allow  this  piece  to  traverse  on  a wood  screw 
by  which  it  is  firmly  held  at  whatever  degree  of 
elevation  or  depression  is  required.  Both  extremi- 
ties of  the  table  are  perforated  in  various  places  by 
small  parallel  mortises  through  which  straps  with 
buckles  are  passed,  for  the  purpose  of  keeping  the 
subject  in  its  place  whenever  the  position  of  the 
table  is  changed. 

The  great  superiority  of  this  table  over  every  other 
consists  in  the  facility  with  which  the  subject  may 
be  moved  in  various  directions,  so  as  to  give  the 
class  better  views  not  only  of  different  parts,  but 
various  views  of  the  same  parts ; and  doing  away 
the  necessity  of  the  clumsy  blocks  commonly  used, 
and  the  unpleasantness  of  calling  in  assistants  to 
drag  the  subject  into  a different  position.  Another 
very  decided  advantage,  is,  that  we  can  with 
this  table  exhibit  almost  every  part  of  the  body  in 
its  natural  situation.  Thus,  we  do  not  show  the 
muscles  destined  to  move  the  arm  and  trunk  with 
the  subject  stretched  horizontally,  but  sitting  up  in 
an  unconstrained  position.  By  this  the  student  is 
saved  the  trouble  of  reversing  every  thing  demon- 
strated, in  his  mind,  in  order  to  get  some  idea  of 


ANATOMICAL  INVESTIGATIONS. 


33 


its  natural  relations.  By  depressing  both  extre- 
mities to  the  utmost,  and  having  the  subject  pla- 
ced directly  over  the  centre,  we  can  with  this  ta- 
ble give  views  of  the  abdomen,  thorax  and  pelvis, 
altogether  impossible  with  the  ordinary  table.  In 
demonstrating  the  brain  or  other  parts  about  the 
head,  we  cannot  with  blocks  do  more  than  raise 
the  head  in  a very  unsteady  manner  to  a cer- 
tain degree,  with  this  table  it  may  be  raised  at 
pleasure,  so  as  not  only  in  an  instant  to  be  de- 
pressed, but  depressed  to  the  slightest  degree,  mo- 
ving the  fourth  of  an  inch  at  each  time  to  accommo- 
date the  head  to  the  immedi^rte  section  made. 

When  we  are  demonstrating  the  organs  of  sense, 
or  other  parts,  where  we  do  not  use  the  whole  sub- 
ject, then  by  elevating  both  leaves  of  the  table  to 
a certain  degree,  and  depressing  the  extremities 
until  they  are  brought  level,  we  are  thus  furnished 
with  two  very  convenient  stands  at  the  ends  of  the 
table,  for  our  specimens  or  preparations,  while  the 
basin,  sponge,  towel,  &c.  may  be  placed  in  the 
centre.  This  arrangement  is  the  more  excellent  as 
it  brings  the  specimens  nearer  to  the  eye  of  the 
student,  and  saves  the  teacher  from  the  fatigue  and 
unpleasantness  of  stooping. 

The  strength  of  this  table  is  very  great  and  far 
beyond  any  weight  to  which  it  is  to  be  subjected. 
The  motions  are  so  easy  and  the  positions  may  be 


84 


AIn ATOMICAL  INVESTIGATIONS. 


varied  Avith  so  much  facility,  that  they  sometimes^ 
are  changed  ten  or  twelve  times  during  a single  lec- 
ture, to  accommodate  to  particular  parts  of  the 
class.  The  circular  motion  is  so  easy,  that  with 
a large  subject  on  the  table,  the  slightest  touch 
is  suflBcient  to  carry  it  round  the  circle.  A full 
view  of  the  table  is  given  in  the  accompanying 
plate. 

The  following  sketches  wilt  give  a good  idea  of 
some  of  the  various  positions  that  this  table  may 
be  placed  in.  Their  uses  will  be  readily  under- 
stood by  any  one  acquainted  with  the  objects  a 
teacher  of  anatomy  has  in  view. 


[Mr.  John  James,  Jr.  No.  24  N.  5th  Street,  who  made  this, 
has  the  model  and  can  furnish  similar  tables  at  a short  notice.] 


A TREATISE 


ON  THE 

MINUTE  ANATOMY 

OP  THE 

© ST  ^9 

TRANSLATED  FROM  THE  LATIN 
0£ 

ANTONIO  SCARPA,  M.  D. 

Professor  of  Anatomy  in  the  University  of  Pavia; 

BT  JOHN  D GODMAN,  M.  D. 

LECTURER  ON  ANATOMY  AND  PHYSIOLOGY, 

PHILADELPHIA. 


A TREATISE 


ON  THE 

MINUTE  ANATOMY 

OF  THE  BONES. 

Although  the  osseous  system  has  for  a long 
time  been  carefully  studied,  and  every  thing  pecu- 
liar to  it  is  thought  to  be  well  known — ^though  we 
possess  both  learned  and  laboured  treatises  on 
the  human  bones,  with  most  beautiful  engravings, 
delineating  them  as  is  said,  <^^to  the  life’’ — and 
though  there  are  many  anatomical  teachers,  who 
(on  account  of  the  immense  quantity  of  minutas 
gradually  accumulated)  hang  over  them  during 
whole  months,  exhibiting  to  their  auditors  all  their 
inequalities,  and  pursuing  every  individual  de- 
pression and  spiracle  to  its  termination — neverthe- 
less, without  sneering  or  arrogance,  it  may  be 
stated  that  an  addition  may  be  advantageously  mad^ 
to  our  knowledge  of  their  minute  anatomy.  Re- 
linquishing and  rejecting  the  hypothesis  pub- 


88 


ANATOMICAL  INVESTIGATIONS. 


lished  by  Gagliardi,  concerning  the  corrugated  la- 
mina, and  the  quadruple  order  of  hooks  joining 
these  lamina  together,  as  well  as  what  Havers  has 
written  relative  to  the  spiracles  conveying  an  oily 
fluid  into  the  bones,  we  shall  find  that  the  more 
recent  doctrines  relative  to  their  minute  anatomy, 
are  neither  more  correct,  nor  more  useful.  Teach- 
ers say,  as  with  one  voice,  announcing  it  as  a 
thing  thoroughly  investigated  and  clearly  esta- 
blished, that  the  bones  are  composed  of  fibres, 
layers,  or  tables,  placed  upon,  or  so  connected  and 
joined  with  each  other,  as  to  have  their  strata  in- 
termingled. They  say,  moreover,  that  the  fibres 
are  stretched  out  in  cylindrical  bones  according  to 
their  length,  but  in  flat  bones  are  disposed  from  the 
centre  to  the  periphery,  and  lastly,  that  the  strength 
of  the  bones  depends  on  the  size,  number,  and 
length  of  the  layers.  Those  who  attempt  to  sup- 
port this  doctrine,  seem  to  have  very  slightly  stu- 
died the  nature  and  truth  of  the  fact,  when  they 
produce  calcined'^  bones,  which  split  into  leaves 
and  tables,  and  add  the  testimony  of  surgeons  who 

* In  my  experiments  to  test  the  accuracy  of  Scarpa’s  observa- 
tions, I found  that  the  apparent  lamination  of  bone  was  never 
produced,  except  when  the  surface  was  suddenly  and  unequally 
heated.  Bones  calcined  with  a slow  and  steady  fire,  never  gave 
me  the  least  appearance  of  tables. 


J.  ]).  O. 


ANATOMICAL  INVESTIGATIONS. 


89 


daily  see  caries  removing  layers  and  plates  from 
the  sound  bone — thus  yielding  their  belief  to  de- 
ceptive appearances,  instead  of  making  anatomical 
researches. 

An  attentive  examination  of  the  minute  structure 
of  the  internal  surface  of  young,  as  well  as  of  the 
.harder  part  of  adult  bones,  will  convince  any  one 
from  the  first  step  that  the  former  doctrines  have 
been  too  hastily  advanced  and  too  rashly  adop- 
ted. A careful  observer  would  find,  that  the  whole 
of  what  is  called  fibre  in  bone,  is  a mere  mistake, 
and  the  short  lines  to  which  name  of  fibre  is  incor- 
rectly given,  occupy  a very  small  space,  and  join  at 
different  angles  with  other  very  short  tracts  of  the 
same  kind,  and  by  their  successive  apposition,  ea- 
sily impose  on  the  careless  observer,  as  if  they 
were  filaments  continued  throughout  the  substance 
of  the  bone.  By  the  use  of  good  microscopes, 
every  one  will  readily  perceive  that  these  tracts  are 
branched* — unite  with  the  nearest  portions  at  an- 
gles of  different  degrees  of  acuteness,  and  being  in- 
terwoven in  a multiplex  way,  constitute  a reticular 

* Malpighi  formerly  observed  the  same  thing,  Anat.  Plantar. 
“ These  filaments  are  not  all  parallel  to  each  other,  and  hence 
short  appendices  are  given  off,  without  being  bound  together,  form 
a wet,  differing  very  little  from  the  nature  of  bark,  the  area  of 
which  being  larger,  and  the  whole  compages  of  fibres  expanding, 
swells  with  an  osseous  juice. 


90 


ANATOMICAL  INVESTIGATIONS. 


structure,  which  may  be  plaiuly  seen  throughout 
the  whole  superficies  of  a bone,  whether  it  be  fiat 
or  cylindrical. 

In  relation  to  the  layers  and  tables  stratified  in 
bones,  every  proper  observer  will  understand  and 
confess,  that  calcination  is  too  rude  a process,  to 
to  give  anatomists  any  right  to  conclude  that  bones 
naturally  are  formed  of  many  strata,  or  by  the 
coalescence  of  superimposed  layers.  Although 
tliese  are  the  hardest  organs  of  animals,  yet  they 
are  not  throughout  the  whole  of  tlieir  peculiar 
structure  of  the  same  density,  and  held  together  at 
all  points  by  an  equally  cohesive  force  ; v hen  acted 
on  by  heat,  they  must  necessarily  separate  une- 
qually and  split  in  strata,  although  this  is  very  far 
from  being  the  natural  structure  of  the  bone.  Be- 
cause during  life  caries  separates  plates  from  the 
bone,  it  is  not  therefore  fair  for  anatomists  to  assert, 
that  the  bones  are  naturally  formed  by  superim- 
posed tables — since  sometimes  the  softest  parts  of 
the  human  body,  and  particularly  the  skin,  is  re- 
moved in  gangrenous  crusts  and  layers,  from  the 
supposed  sound  parts,  while  there  is  nothing  better 
ascertained  in  the  whole  human  structure,  than  that 
the  substance  and  texture  of  the  skin  ditters  as 
much  as  possible  from  lamination. 

Not  only  is  the  outer  surface  of  the  bone,  which 
may  be  easily  seen  by  any  one,  of  this  character, 


AXAT(JM1GAL  IX VES'l  KiATiOXS.  Si 

but  1 pronounce  and  affirm  that  even  the  greatest 
part  of  the  whole  osseous  system  is  reticular  or 
cellulous.  To  demonstrate  this  I do  not  impose  a 
very  severe  task  on  myself.  It  will  be  sufficient  to 
show  all  the  bones  split,  as  Cheselden  did,  and  I 
was  accustomed  to  do  during  many  years,  before 
my  class.  By  this  simple  method  of  treating  the 
whole  skeleton,  it  is  made  evident  at  a glance  even 
to  the  most  inexperienced,  that  the  largest  portion 
of  the  bones  is  cellulous  or  reticular — the  residue 
being  a hard  concrete  and  stony  substance  which 
surrounds  the  reticular  structure  like  a bark. 
The  quantity  of  this  cortical  matter  in  proportion  to 
the  spongy  part  is  very  small  in  the  scapula  and 
ilia,  and  is  still  smaller  in  the  bodies  of  the  ver- 
tebrae, when  a large  mass  of  spongy  substance  is 
but  slightly  covered  by  a thin  bony  crust.  The 
lower  jaw  clavicle,  and  especially  the  sternum  and 
ribs  are  in  great  part  spongy.  The  bones  of  thfe 
carpus,  metacarpus,  tarsus  and  metatarsus,  and 
joints  of  the  finger  and  toes,  have  a quantity  of 
spongy,  loose,  and  cellular  texture,  so  far  exceed- 
ing their  external  crust,  that  the  bones  of  the  hand 
and  feet  may  without  impropriety  be  termed  spongy. 
In  relation  to  the  rest  of  the  joints,  it  is  very  com- 
monly known,  that  the  middle  of  the  cylindrical 
bones,  as  the  arm  and  thigh  bones,  the  radius,  ulna, 
tibia,  and  fibula,  are  very  hard  and  firm,  but  as  we 


92 


A X A 1 ()  M 1 C A L 1 N V E STl  (4  AT  I O N S. 


gradually  approach  their  extremities,  the  texture 
becomes  looser,  and  they  swell  out  in  light  and 
spongy  protuberances  covered  by  a thin  external 
osseous  sheet.  Not  only  do  we  observe  this  in  all 
the  bones  of  the  skeleton,  but  in  the  cartilages,  as 
those  of  the  ribs  and  of  the  larynx,  which  some- 
times, though  rarely  do  ossify.  When  these  are 
split  through  the  middle,  there  will  be  perceived 
nearly  the  same  proportion  as  in  the  true  bones, 
between  their  external  compact  crust  and  their  re- 
ticulated alveolar  substance. 

The  whole  controversy,  therefore,  relative  to  the 
minute  anatomy  of  the  bones,  as  far  as  I can  judge, 
returns  to  this — not  whether  the  structure  of  the 
greatest  part  of  the  bones  is  generally  cellular  or 
not,  (as  this  is  sufficiently  proved  by  the  sections 
made  with  the  saw  before-mentioned,)  but  whether 
the  hard  and  almost  rocky  walls  of  the  bones,  and 
their  compact  external  crust  no  less  than  their  in- 
ternal substance,  partake  of  this  cellular  texture. 
That  I may  answer  this  question  as  satisfactorily 
as  possible,  I have  thought  it  best  first  to  investi- 
gate the  subject  synthetically,  and  then  analyti- 
cally. Hence  1 began  by  examining  the  bones  in  the 
first  rudiments  of  animation,  that  is,  when  the  car- 
tilage first  changes,  and  the  earliest  traces  of  the 
future  bone  begin  to  appear  at  the  same  time. 
Then  1 deprived  the  hardest  bones  of  an  adult  of 


ANATOMICAL  INVESTIGATIONS. 


93 


their  earthy  particles,  and  reduced  them  to  their 
original  softness  and  pellucidness,  thinking,  as  was 
proved  by  the  experiment,  that  however  entire  the 
maturity  of  these  bones  might  be,  their  minute 
structure  would  exhibit  the  same  order  and  rela- 
tion as  was  seen  in  the  embryos.  I therefore  re- 
peated Haller’s  experiments  on  the  formation  of 
bone,  in  the  incubated  egg,  the  chief  of  which  I 
subjoin  entire,  as  they  are  recorded  in  my  notes. 

Eighth  Day  of  Incubation. 

The  femur  and  tibia  were  properly  formed,  but 
entirely  cartilaginous,  flexible,  pellucid,  in  w'hich 
no  dissimilar  point  could  be  observed  with  the 
most  powerful  glasses.  When  dried  they  had  the 
appearance  of  desiccated  gum. 

JV*inth  Day. 

A yellowness  begins  to  appear  about  the  middle 
of  the  femur  and  tibia.  The  cartilage  in  Wrai  julace 
begins  to  be  somewhat  wrinkled  and  crisped,  but 
the  rest  light  and  pellucid. 

Tenth  Day. 

The  femur  and  tibia  much  more  yellow  and 
wrinkled  in  the  middle  than  yesterday.  These 


94 


ANATOMICAL  IN VESTIGATiOXS. 


twinkles  magnified  by  a good  microscope,  exhi- 
bited a very  beautiful  network,  the  lines  mutually 
concurring  at  acute  angles — yet  this  network  was 
still  cartilaginous  and  flexible,  differing  in  nothing 
from  the  rest  of  the  cartilage  of  the  future  bone,  ex- 
cept in  opacity,  yellowness,  and  a slight  degree  of 
roughness. 

Eleventh  Day. 

In  the  middle  of  the  femur  and  tibia  the  rough- 
ness, or  network,  begins  to  harden.  Being  dried 
both  sustain  themselves  by  the  middle,  while  the 
rest  of  the  cartilage  of  the  tibia  and  fibula  collap- 
ses and  appears  like  a gummy  substance.  The 
middle  portion,  which  is  not  destroyed  by  drying, 
is  a bony,  rough  reticulated  crust,  which  is  only  a 
little  thicker  in  the  middle  than  at  the  extremities. 
Moreover,  near  the  lower  part  of  the  tibia  and  fi- 
bula, red  spots  begin  to  appear,  which  show  the 
situation  of  the  inferior  nutritious  artery. 

» Twelfth  Day. 

About  the  middle  of  the  tibia,  the  network,  or 
original  ossification,  is  terminated  by  two  red  points, 
one  above  and  the  other  below.  The  superior  nu- 
tritious artery  begins  to  be  visible.  The  bone 


ANATOMICAL/  INVESTIGATIONS. 


95 


when  dried,  preserves  its  cyiindric  form  in  the 
middle. 

Fourteenth  Day'. 

The  opake,  reticular,  and  anteriorly  osseous 
middle  of  the  femur  and  tibia,  is  perceptibly  ex- 
tended towards  the  extremities,  and  terminates  in 
both  directions  in  'zones,  very  full  of  red  blood, 
surrounding  both  ends.  These  very  delicate  be- 
ginnings of  ossification  are  very  plainly  discovera- 
ble by  microscopes  of  ordinary  power,  and  show 
that  the  structure  of  the  bone  is  by  no  means  fi- 
brous, but  altogether  reticular,  cellulous,  and  floc- 
culent,  and  is  manifestly  formed  from  very  short 
lines  or  tracts  running  together  at  acute  angles. 

Fifteenth  Day. 

The  whitish,  reticulated  osseous  substance  is 
much  more  extended  towards  the  epiphyses.  The 
zones  of  blood-vessels  situate  at  the  extremities  of 
the  ossification,  were  broader  and  exhibited  a more 
vivid  redness.  The  reticulated  osseous  structure 
was  very  conspicuous  to  the  naked  eye.  Splitting 
the  femur  and  tibia  in  their  length,  the  internal 
part  of  the  bony  tube  was  formed  of  reticulated 
matter— the  walls  of  the  tube  throughout  their 


96 


ANATOMICAL  INVESTIGATIONS. 


whole  length  were  downy  or  flocculent,  having  no 
vestige  of  tables  or  lamina  arranged  over  one  ano- 
ther. But  the  blood-vessels  which  went  from  the 
zones^  from  the  beginning,  both  in  giving  and  re- 
ceiving the  little  twigs,  follow  precisely  the  same 
order,  and  exhibit  the  reticular  structure. 

Sixteenth  Day. 

The  reticular  osseous  structure  of  the  femur  and 
tibia  reaches  nearly  to  the  epiphyses — even  on  the 
cartilage  which  tips  the  extremity  of  the  bone,  a 
rough  surface  is  visible,  which  is  the  rudiment  of 
the  future  bone — and  nothing  is  wanting  to  change 
this  roughness  into  real  bone,  but  the  deposition 
of  earthy  particles.  The  redness  of  the  zones 
is  greater  than  on  the  fifteenth : from  either  ex- 
tremity of  the  bone,  towards  the  middle  it  is  in- 
creased and  expanded,  so  that  the  whole  bone 
seems  suffused,  as  with  a sanguineous  dew.  The 
femur  being  split  through  its  length,  gave  no  indi- 
cation in  any  part  of  the  bony  tube  of  a lamellated 
structure,  but  every  where  appeared  flocculent,  re- 
ticulated and  cellular. 

-Eighteenth  Day. 

The  reticulated  osseous  crust  occupies  the  whole 
of  both  bones,  except  a small  part  of  the  cartilage 


ANATOMICAL  INVESTIGATIONS.  97 

on  the  extremities  of  the  tibia  and  fibula.  The  su- 
perior and  inferior  vascular  zones  are  very  much 
expanded,  and  nearly  meeting  and  intermixing 
with  each  other  in  the  centre,  tinge  the  whole  femur 
and  tibia  with  redness.  Both  bones  being  split 
in  their  length,  their  walls  throughout  appear  al- 
veolar and  cellular,  and  also  stronger  than  in  the 
sinuosity  of  the  femur  of  the  opposite  side.  The  tube 
of  both  bones  was  here  and  there  interrupted  and  con- 
fined by  cartilaginous  partitions.  The  internal  pe- 
riosteum, exhibited  the  appearance  of  many  blood- 
vessels collected  together,  and  was  intensely  red. 
But  near  the  epiphyses,  the  cartilage  which  remain- 
ed of  the  diaphysis  of  the  whole  bone,  was  elongated 
in  the  form  of  a cone  in  the  medullary  tube,  or 
bony  pipe,  which  cone  gradually  terminated  in  a 
point  near  the  middle  of  the  bone.  Through  this 
cartilaginous  cone  on  the  extremities  of  the  bones, 
some  vessels  passing  from  both  %ones,  reach  to  the 
epiphyses  with  a bifurcated  termination.  The  front- 
tai  bones  were  still  very  flexible,  and  almost  carti- 
laginous, yet  were  in  no  point  fibrous,  being  in  all 
parts  manifestly  reticulated. 

Tioenty-jirst  Day. — A chicken  near  being  hatched. 

The  femur  and  tibia  were  not  so  red  externally, 
as  on  the  former  days.  In  the  middle  of  both 

N 


98 


ANATOMICAL  INVESTIGATIONS. 


bones  the  reticular  structure  was  more  close  and 
compact  than  usual,  and  the  lines  appeared  to 
run  together  at  more  acute  angles  than  on  the 
first  days  after  incubation— -hence  it  happens  that 
those  small  tracts  concurring  at  acute  angles 
readily  deceive  superficial  observers,  as  if  they 
were  fibres  extended  in  the  length  of  the  bone. 
The  femur  and  tibia  being  vertically  divided,  the 
internal  periosteum  presented,  covered  by  an  oily 
mucus,  and  he  medullary  tube  was  filled,  by  small 
cartilaginous  tubercles.  But  in  the  extremities  of 
the  same  bones,  the  cartilage  which  rose  in  the 
form  of  a cone  through  the  bony  tube,  was  changed 
to  a pellucid  sponge  of  cartilaginous  elasticity, 
grooved  by  oblong  depressions  and  sinuses.  It  ne- 
cessarily follows,  from  the  evolution  of  this  conical 
cartilage,  and  from  the  separation  of  the  same  into 
pits  and  cells,  that  the  proportion  of  these  protu- 
berances is  very  much  increased  at  the  diaphysis 
of  the  bones,  on  account  of  their  greater  amplitude 
and  the  swelling  of  this  conical  cartilage^  which 
far  exceeds  the  diameter  of  the  bony  tube. 

A chicken  two  days  before  being  hatched. 

There  was  nothing  of  cartilage  in  the  extremi- 
ties of  the  femur  and  tibia,  except  the  epiphyses. 
When  the  periosteum  was  removed,  the  blood- 


ANATOMICAL  INVESTIGATIONS.  99 

vessels  appeared  every  where  mixed  and  inter- 
woven with  the  bony  net-work.  Both  bones  being 
divided  as  usual,  the  internal  periosteum  was  very 
red,  and  the  vessels  of  the  marrow,  bedewed  with 
much  oily  mucus,  were  extended  from  the  extremi- 
ties toward  the  centre  of  the  bone.  In  the  middle 
of  the  femur  and  tibia,  where,  from  the  commence- 
ment of  the  ossification,  the  whole  external  surface 
of  the  bony  tube  was  downy  and  flocculent  was 
now  seen  a hardened  covering,  manifestly  drawn 
and  crowded  together  in  tracts  and  areolae  of  reti- 
cular structure.  The  cartilaginous  cone  which  I 
saw  on  the  former  days  in  both  extremities  of  the 
bone,  drawn  out  into  depressions  and  little  cir- 
cles, and  very  tumid,  I find  has  become  a fragile, 
bony  sponge,  forming  the  protuberance  of  the  bones. 
Moreover,  I again  see  red  vessels  pass  from  both 
extremities  of  the  bone  to  the  epiphyses,  to  form 
the  ossification  of  their  cartilaginons  appendages  in 
the  usual  way. 

Thus  far  the  observations  were  made  on  the  in- 
cubated egg,  and  the  original  structure  of  bone  in 
human  embryons  when  about  twenty-eight  lines 
long.  For  in  these,  as  in  the  chick  about  the  four- 
teenth day  of  incubation,  the  middle  of  the  femur 
and  tibia,  which  scarcely  equalled  two-thirds  of  the 
whole  length  of  the  bone,  was  osseous— the  re- 


100 


ANATOMICAL  IN  VESTIGATION  S. 


raaiiider  was  cartilaginous.  The  external  surface 
of  both  bones  stripped  of  the  periosteum,  and  exa- 
mined with  the  best  glasses,  appeared  beautifully  re- 
ticular, very  short  braucbiug  lines  running  toge- 
gether  at  acute  angles,  altogether  resembling  the 
first  evolutions  of  the  bones  in  the  incubated  egg. 
The  embryon  bone  split  through  the  middle,  exhi- 
bited the  downy  and  flocculent  substance  both  in- 
ternally and  externally.  Although  the  frontal  and 
occipital  bones  were  so  pellucid  and  flexible  that 
they  appeared  entirely  cartilaginous,  yet  the  mi- 
nute structure  was  manifestly  reticular — both  the 
whole  of  the  scapulse  and  ilia  were  spongy,  being 
still  unprovided  with  any  harder  external  cove- 
ring. 

The  conclusions  which  are  to  be  drawn  from 
these  observations,  unless  I am  very  much  de- 
ceived, are  the  following ; 

1.  That  the  cartilages  were  the  models  of  the 
future  bone,  and  all  the  parts  of  the  bone  visible, 
existed  in  the  form  of  cartilage. 

2.  The  reticular  or  cellulous  bony  structure 
which  first  began  to  appear  about  the  middle  of  the 
cylindrical  bones,  was  always  immediately  prece- 
ded by  a wrinkling  of  this  part. 

3.  That  the  cartilaginous  model  is  changed  to 
bone  by  the  action  of  the  sanguiferous  vessels  and 


ANATOMICAL  INVESTIGATIONS.  101 

the  addition  of  earthy  matter,  in  the  rugose  cartila- 
ginous tracts,  by  which  means  the  osseous  net- work 
is  made. 

4.  In  the  incipient  state  of  ossification,  the 
Avhole  height  and  thickness  of  the  bony  pipe  of  the 
cylindrical  bones,  both  without  and  within,  is  light, 
downy  and  cotton  like,  having  no  trace  of  hard  co- 
vering externally. 

5.  When  the  ossification  is  perfected,  the  walls 
of  the  cylindricial  bones  receive  an  increase  of 
density  about  the  middle  of  the  bone,  with  a di- 
minution of  breadth,  as  the  reticular  texture  is  more 
closely  drawn  together  than  before,  and  compacted 
in  the  tracts  and  alveoli.  What  forms  the  exter- 
nal crust  or  cortex  of  the  bone,  is  nothing  more 
than  the  light,  reticulated  cellulous  structure  brought 
into  a hard  body  near  the  surface  of  the  bone ; and 
this,  both  in  the  cylindrical  and  flat  bones,  does 
not  appear  about  their  middle  or  centre,  before  the 
entire  ossification  of  the  cartilaginous  model. 

6.  The  sponginess,  which  is  greatest  in  the  ex- 
tremities of  long  bones,  is  by  no  means  derived,  as 
many  anatomists  teach,  from  those  lamina,  or  ta- 
bles, which  pass  from  the  walls  of  the  bony  tube 
and  go  into  the  medullary  cavity,  but  it  is  to  be 
referred  to  the  primordial  cartilage,  which  at  first 
stretches  the  cones  upwards  through  the  medullary 


102 


ANATOMICAL  INVESTIGATIONS. 


cavity,  and  at  length  the  areolse  and  cancelli  being 
removed,  expands  more  fully,  and  swells  very  much 
like  tuberous  sponge  in  the  extremities  of  the  long 
bones. 

7.  Finally,  the  original  more  minute  texture  of 
the  cylindrical  and  flat  bones,  both  in  the  incuba- 
ted egg  and  the  very  early  human  foetus,  (when  in- 
deed both  the  bones,  scarcely  begun,  are  still  flexible 
and  light,)  are  nothing  but  a slightly  reticulated  or 
cellular  substance — and  moreover,  if  sometimes 
distinct  little  spots,  remote  from  the  centre  of  ossi- 
fication, occur  in  the  progress  of  ossification,  they 
are  at  length  consolidated  and  peculiarly  inter- 
woven with  the  portions  next  them,  the  whole  bone 
being  thus  formed  of  retiform  structure. 

In  the  next  place,  since  we  find  this  to  be  the 
fact  in  the  first  evolution  of  bone,  let  us  consider 
the  more  minute  structure  of  the  bones  in  detal — 
especially  the  nature  of  the  corticil  substance  of 
the  bone,  which  is  most  manifestly  made  up  from 
the  compacted  osseous  net-work.  This,  which  has 
been  detected  by  the  synthetic  method,  I felt  sure 
of  confirming  by  analysis,  as  the  hard  external  of 
bones  could  be  wholly  cleared  of  their  earthy  par- 
ticles, and  then  might  be  gradually  loosened,  until 
their  peculiar  structure  could  be  fairly  shown. 

Therefore  I kept  the  tibia  of  an  adult,  in  dilute 


ANATOMICAL.  INVESTIGATIONS.  103 

muriatic  acid  sufficiently  long  to  extract  the  earthy 
particles — by  this  process,  common  to  anatomists, 
the  very  hardest  bones  are  converted  into  a cartila- 
ginous substance  of  great  flexibility  and  translu- 
cency,  without  in  the  slightest  degree  changing 
their  natural  forms.  When  I had  reduced  these 
bones  to  this  state,  I mascerated  the  cartilaginous 
residue  in  pure  water,  in  the  same  manner  as  is 
done  when  we  wish  to  reduce  membranes,  viscera, 
skin,  tendons,  or  aponeuroses  to  cellular  substance. 
By  a long-  continued  experience,  I have  at  length 
learned  to  reduce  the  external  covering  of  the  tibia 
of  an  adult  to  a downy  reticular  texture,  similar  to 
that  which  is  found  in  the  extremities  of  the  bone, 
except  that  the  close  and  much  compressed  texture 
of  the  cortex,  appears  loose  and  dissolved,  in  the 
meditullium  and  tuberosity  of  the  same  tibia.  In 
fact  wdien  the  parenchyma  of  the  tibia  was  cut  per- 
pendicularly, no  vestige  was  found  either  externally 
or  internally  of  fibres,  not  the  slightest  indication 
of  lamination,  or  plates,  in  the  thickness  of  the  bony 
tube — but  the  whole  of  the  hardest  crust  of  the  tibia 
throughout  its  extent,  appeared  to  be  formed  of 
cellulous  structure,  so  disposed  in  cancelli  and  tracts 
of  net-work,  that  what  belonged  to  the  superficies 
of  the  tibia  was  much  compressed  and  gathered  on 
itself.  The  cancelli  gradually  relaxed,  and  en- 


104 


ANATOMICAL  INVESTIGATIONS. 


largeil  more  and  more,  until  they  were  swelled  out 
to  that  sponginess  found  in  the  medullary  cavity 
and  extremities  of  the  bone.^ 

I have  with  much  pleasure  observed  that  the 
compact  substance  of  the  tibia  now  under  conside- 
ration, is  of  a cellulous  reticular  structure,  when 
this  cortex  has  been  deprived  of  its  earth  and  mois- 
ture, and  afterwards  placed  in  oil  of  turpentine. 
For  on  account  of  the  high  degree  of  pellucidness 
of  a bone  thus  treated,  the  slight  net- work  of  which 
it  is  ultimately  composed,  may  be  clearly  seen — 
and  the  naked  eye,  can  discover  without  error, 
that  the  very  hard  crust  of  bone  is  really  of  a cot- 
ton-like texture,  and  made  up  of  very  short  branch  > 
ing  tracts,  variously  joined  and  interwoven. 

The  same  circumstances  were  manifested  by  a 
section  of  the  very  hardest  portion  taken  from  the 
middle  of  an  adult  tibia,  suspended  in  spirits  of 
wine  after  the  earthy  matter  was  removed,  and 
carefully  examined  by  reflected  and  refracted  light. 
The  soft  cellulous  texture  was  shown,  in  which 
small  cones  of  the  same  soft  substance  of  different 

* I have  repeated  all  Scarpa’s  experiments  on  adult  bones,  and 
have  examined  in  the  same  manner  the  very  hardest  parts  of  the 
cylinder  of  the  thigh  bone.  The  results  have  been  so  uniformly 
similar  to  those  above  related,  that  it  is  not  possible  to  avoid  adop- 
ting the  author’s  conclusions. 


J.  D.  O 


ANATOMICAL  INVESTIGATIONS. 


105 


figures  adhering  together,  formed  here  and  there 
larger  and  smaller  areolae,  nearly  like  the  soft  cel- 
lular texture. 

The  reticular  structure  is  not  only  to  be  seen  in 
the  cylindrical,  but  also  in  the  compact  tables  of  the 
flat  bones  in  adults.  Thus  the  internal  and  exter- 
nal crust  of  the  frontal  and  occipital  bones,  being 
made  flexible  and  pellucid,  and  suspended  in  oil 
of  turpentine,  the  whole  is  found  to  be  in  every 
part  reticular.  So  great  is  the  resemblance  of  this 
crust  to  the  structure  of  cellular  texture,  that  it 
might  readily  be  mistaken  for  a membrane  reduced 
to  a cellular  web,  by  long  continued  maceration. 
However,  I have  remarked  the  form  of  the  cells  in 
in  the  crust  of  flattened  bones,  to  be  different  from 
those  peculiar  to  the  net- work  of  cylindrical  bones  ; 
that,  for  instance,  the  areolae  in  flat  bones  are  more 
oblong  than  in  the  cylindrical — as  if  the  cellulous 
spaces  and  areolas  of  tlie  flat  bones  had  been  drawn 
in  different  directions,  while  the  bones  were  yet 
soft  and  cartilaginous.  Hence  analytic  examina- 
tion of  the  cortex  of  hard  adult  bones,  shows  that 
there  is  almost  the  same  disposition  of  principles  in 
the  construction  of  the  hardest  parts  of  their  bones, 
as  in  the  embryo  at  their  first  evolution  j and  the  con- 
version of  cartilage  into  bone — that  all  the  bones, 
even  the  very  hardest,  are  composed  of  a collection 
of  small  tracts,  which  extend  through  very  short 

O 


106 


ANATOMICAL  IN  VKSTIGA'ITON  S, 


spaces,  and  unite  at  different  angles,  forming  a 
net  work.  It  is  not  from  conjecture,  therefore,  but 
the  force  of  positive  observation,  that  we  declare 
the  opinion  hitherto  taught  in  anatomical  schools, 
that  bones  are  formed  by  tables,  lamina,  and  fila- 
ments, is  unfounded,  and  must  be  rejected  as  un- 
true— and  we  aflSrm,  that  all  the  bones,  whatever 
be  their  figures,  are  in  their  minute  structure  cellu- 
lous  and  reticular,  sometimes  very  close  and  com- 
pact, as  in  the  cortex  of  very  hard  bone — at  others, 
loose  and  free,  as  in  the  cavities  and  tuberous  ex- 
tremities of  cylindrical  bones.  Those  short  tracts 
which  anatomists  have  mistaken  for  bony  fibres,  can 
neither  be  followed  in  the  length  nor  breadth  of  the 
bone,  nor  do  they  ever  attain  any  notable  length. 

In  fact,  as  often  as  I attentively  examine  the  mi- 
nute cellular  texture  under  consideration,  and  ob- 
serve that  it  is  very  close  and  compact  at  the 
surface,  and  grows  gradually  looser  and  looser  as 
it  approaches  the  internal  part,  and  the  spaces  and 
cells  become  very  much  larger,  and  at  length  form 
the  spongy  structure  of  the  meditullium,  and  extre- 
mities of  the  bones,  I cannot  avoid  concluding  that 
there  is  in  this  construction  of  the  bones,  a great 
resemblance  with  the  texture  of  the  true  skin  of 
animals.  For  this  corium,  which  is  beyond  doubt 
of  a cellular  texture,  where  it  covers  the  external 
surface,  has  its  cells  drawn  together  and  closely 


ANATOMICAL  INVESTIGATIONS. 


107 


compressed,  is  very  firm  and  compact,  but  its  in- 
ternal surface,  has  its  cellular  structure  more  and 
more  relaxed  and  enlarged,  till  at  length  by  the  in- 
troduction of  air  it  is  easily  swollen,  the  and  sub-cu- 
taneous net- work  is  loosened  and  enlarged.  Thus 
in  bones  I see  a cellulous  net-work,  very  close  and 
firm  on  the  outer  surface  of  the  bone  forming  a hard 
crust,  and  the  same  substance  gradually  becoming 
loose  toward  the  centre  of  the  bone,  enlarging  and 
swelling  out  to  an  osseous  sponge. 

Since  then  it  is  demonstrated,  that  the  minute 
structure  of  the  crust  and  meditullium  of  bone  is 
entirely. of  the  same  cellular  structure,  it  will  not  be 
difficult  unless  I am  much  mistaken,  to  understand 
why  the  cylindrical  bones  of  very  young  foetuses, 
which  in  the  beginning  throughout  the  whole  extent 
of  the  walls  of  the  long  tube,  are  equally  liglit  and 
cotton-like,  should  with  increase  of  age  be  exter- 
nally covered  by  a hard  and  compact  crust — also 
why  it  happens  that  the  cortex  of  the  bone  is  uni- 
formly in  inverse  proportion  to  the  meditullium,  or 
what  is  more  remarkable,  why  the  cortex  should 
be  thick  and  very  hard  where  the  spongy  substance 
is  in  smallest  quantity — and  on  the  contrary,  the 
cortex  is  slightest  where  it  covers  the  greatest 
quantity  of  spongy  texture.  From  what  I have  ad- 
vanced relative  to  the  commencement  of  ossification 
in  the  incubated  egg,  and  in  the  human  fcetus,  it 


10b 


A N A T U M i C A C 1 N V E S 1 ' 1 G A T I O N S . 


appears,  that  perhaps,  a greater  quantity  of  osseous 
substance  does  not  exist  in  the  middle  of  cylindri- 
cal bones  than  in  their  extremities,  that,  such  is  the 
condition  of  the  cartilaginous  model  of  the  future 
bone,  that  the  portion  of  this  cartilage  belonging  to 
the  extremities,  which  hardens  latest,  is  more  ex- 
tended and  spread  out  over  larger  spaces,  alveoli 
and  depressions,  than  the  middle  portion  of  the 
cartilaginous  model.  Therefore,  since  the  texture 
of  the  cortex  and  meditullium  is  entirely  the  same 
as  before  stated,  reticular  and  cellidoiis,  nature  in 
her  own  way  and  at  the  proper  place,  as  in  the 
middle  of  the  cylindrical  bones,  constriuges  and 
compacts  it  to  form  a hardened  cortex — but  in 
other  parts,  as  in  the  tuberous  extremities  of  bones, 
she  loosens  and  spreads  the  same  material  like  a 
sponge.  In  fact,  no  one  should  think  this  compac- 
tion and  change  of  a lax  cellular  texture  into  a 
solid  and  hard  body  to  be  the  only  example  occur- 
ring in  the  animal  economy,  and  merely  contrived 
and  designed  for  giving  strength  to  the  bones,  since 
nature  employs  exactly  the  same  means  in  all  ani- 
mals, and  in  all  organs  composed  in  a great  degree 
of  soft  cellular  texture,  for  keeping  them  in  their 
places,  and  giving  them  more  solidity  and  strength. 
If  this  should  appear  doubtful,  nature  herself 
teaches,  that  the  soft  membranes  of  the  embryon 
are  changed  and  hardened  into  firm  tunics,  elastic 


ANATOMICAL  INVESTIGATIONS.  109 

ligaments,  and  tendons,  articular  capsules,  and  vas- 
cular coats.  Those  who  have  hitherto  supposed 
the  minute  structure  of  bones  to  be  formed  in  strata 
and  tables,  have  been  accustomed  to  support  their 
notion  by  imagination,  fancying  that  the  middle  of 
of  every  cylindrical  bone,  when  it  is  hardest  and 
firmest,  is  composed  of  numerous  tables,  and  as  we 
gradually  recede  from  this  tabulated  centre  towards 
the  extremities,  tliat  they  become  diminished  in 
length,  and  those  that  are  turned  towards  the  me- 
dullary cavity,  become  so  inclined,  that  at  length 
meeting  together  in  the  middle  of  the  bone,  they  are 
in  a multiplex  manner  admixed  and  interwoven  with 
each  other,  and  changed  into  the  spongy  substance 
of  the  meditullium  and  tubers.  The  whole  of  this 
hypothesis  falls  of  itself,  if  the  facts  are  properly 
weighed,  which  we  have  demonstrated  relative  to 
the  minute  primordial  celliilo-reticular  textures  of 
bone.  Moreover,  even  this  tabular  structure  ad- 
mitted, it  would  be  impossible  to  understand  how 
the  same  strata  of  bone  could  be  driven,  as  Haller 
thinks  by  the  dilatation  of  the  arteries,  from  the 
superficies  of  the  bone  towards  its  medullary  tube, 
till  at  length  by  their  meeting,  the  form  and  condi- 
dition  of  a spongy  mass  is  produced. 

But  although  the  natural  course  and  order  of  os- 
sification is,  that  the  cellulo-reticular  substance 
which  is  placed  in  the  middle  of  the  !)ones,  should 


110 


ANATOMICAL  INVESTIGATIONS. 


change  with  the  maturation  of  the  animal,  gradually 
contracting  its  cells,  and  hardening  the  little  por- 
tions of  cellular  texture — and  while  solidifying,  the 
cellulo-reticular  structure  of  the  extremities  and 
tuberosities,  should  at  the  same  time  extend  the  can- 
celli,  and  enlarge  the  net- work,  so  as  to  increase 
the  whole  size  of  the  bone — nevertheless,  observa- 
tions furnished  by  pathology  are  not  wanting,  to 
show  that  a faculty  and  aptitude  exists  in  the  very 
hardest  cortex  of  adult  bones,  which  enables  them 
under  certain  circumstances,  like  the  cellulous 
structure  of  the  extremities,  to  swell  and  enlarge 
beyond  their  natural  condition. 

Although  1 had  suspected  that  this  remarkable 
power  of  nature  in  relaxing  and  enlarging  the  ex- 
ternal covering  of  the  hardest  bones,  was  often  re- 
sorted to  by  her  in  curing  diseased  bones,  yet  I 
never  was  so  clearly  and  undeniably  satisfied  of  it, 
as  in  the  case  of  a puppy,  whose  leg  I had  freely 
broken.  I opened  the  tibia  of  this  dog,  down  to 
the  miditullium,  and  by  this  opening,  introduced  a 
probe  and  destroyed  the  marrow  of  the  bone,  fil- 
ling up  the  cavity  with  lint,  not  without  much  in- 
jury to  the  inner  wall  of  the  tube.  On  the  follow- 
ing day  the  whole  leg  swelled  violently.  About 
the  sixth  day,  a free  discharge  of  pus  ensuing,  the 
tumefaction  of  the  soft  parts  about  the  wound  sub- 
sided— the  tibia  at  the  same  time  was  found  to  he 


ANATOMICAL  INVESTIGATIONS. 


Ill 


very  tumid,  and  gradually  to  increase  in  size,  until 
about  the  fortieth  day,  it  had  the  appearance  of  a' 
great  exostosis.  The  dog  was  killed,  and  this 
tibia  was  examined  by  cutting  through  its  length, 
when  the  whole  of  the  cortex  was  found  to  be  ex- 
panded to  cellulous  texture,  and  moreover,  the  walls 
of  the  tibia  of  this  puppy  that  were  scarce  half  a 
line  in  thickness,  were  now  changed  into  a spongy 
substance,  of  more  than  six  lines  in  thickness 
throughout  the  length  of  the  bone. 

Similar  circumstances  are  frequently  found  in 
the  human  race,  as  when  any  cause  injures 
the  meditullium  of  bones  leaving  the  corticil  part 
untouched,  or  when  the  nutrition  and  increment 
of  the  bone  from  the  internal  texture  is  injuri- 
ously hindered  by  the  presence  of  some  foreign 
body.  For  in  either  case  nature  provides  for  the 
preservation  of  the  continuity  and  strength  of  the 
diseased  bones,  relaxes  with  great  eifort  their  com- 
pact external  surface,  which  enlarging  to  a spongy 
consistence,  and  being  prolonged  internally,  com- 
pensates for  the  loss  of  the  meditullium — or  swel- 
ling outwards  increases  the  height  and  breadth  of 
the  bony  tube — or,  at  length  by  surrounding  the 
injured  bone  with  the  sponginess  from  the  cortex, 
receives  and  contains  it  in  a sort  of  sheath.  This 
spongy  sheath  in  the  beginning  is  light,  flexible, 
and  cotton-like,  but  gradually  hardening  by  the 


112 


ANATOMICAL  INVESTIGATIONS. 


acquisition  of  earthy  matter,  itjcomes  at  last  to  per^ 
form  the  office  of  the  sound  bone — the  primitive 
bone  wastes  away,  and  at  length  loses  its  continuity 
with  the  osseous  case. 

We  may  reasonably  demand  of  those  who  teach 
that  the  hard  w alls  of  bones  are  made  from  many 
plates  or  tables  superimposed,  how  they  can  re- 
concile such  facts  with  their  hypothesis.  For  it  is 
certain  and  manifest  under  the  circumstances  men- 
tioned, that  the  bones  neither  separate  into  layers, 
nor,  properly  speaking,  does  nature  generate  a 
new  bone  to  replace  the  miditullium,  or  to  include 
the  injured  internal  wall  in  the  bony  sheath,  but 
only  allows  the  compact  and  much  compressed  tex- 
ture of  the  outer  part  of  the  bone  to  become  freely 
enlarged  and  expanded. 

But  while  engaged  in  writing  this  essay,  1 have 
before  me  another  most  excellent  example  of  this 
change  and  transition  of  the  compact  substance  of 
the  bone  into  a cellular  mass,  furnished  by  the 
bones  of  children,  in  whom  the  hardest  parts  of 
the  bone,  and  especially  of  the  joints,  are  reduced 
by  disease  to  the  softness  of  wax,  and  become 
almost  pellucid.  In  consequence  of  this  disease, 
the  bones  being  deprived  of  their  earthy  particles, 
or  the  necessary  deposit  of  earth  withheld,  grow  at 
last  so  soft  and  pellucid,  as  to  be  easily  cut  with  a 
knife,  exactly  like  those  bones  which  have  long 


ANATOMICAL  INVESTIGATIONS. 


113 


?)eeii  macerated  in  diluted  mineral  acids.  Diseased 
bones  of  this  kind  have  their  substance  like  carti- 
lage, very  light  and  flexible,  and  more  delicate  and 
spongy  within  than  it  is  possible  to  describe. 
Having  cut  one  of  them  through  its  length  and  sus- 
pended it  in  spirits  of  turpentine,  it  was  translu- 
cent like  jelly,  exhibiting  the  minute  structure 
throughout  reticulated,  and  particularly  evinced 
and  conflrmed  the  fact  of  the  cellular  nature  of 
the  external  crust  of  bone. 

While  speaking  of  bones  deprived  of  their 
earthy  matter  by  disease,  it  presents  a fair  oppor- 
tunity for  observing  what  happens  sufficiently  often, 
that  bones  from  some  peculiar  virus  may  become 
diseased,  not  throughout  the  whole  body,  as  in  ge- 
neral rachitis,  with  softening,  but  are  deprived  of 
their  earth  in  a particular  spot,  and  are  affected  by 
a local  rachitis,  making  them  soft  within  certain  de- 
fined limits.  Where  this  occurs,  the  cellular  tex- 
ture of  the'  bone  loses  its  character  and  rigidity  as 
bone,  at  the  point  whence  the  earthy  matter  is  re- 
moved, and  assumes  the  flexibility  and  ductility  of 
cartilage,  becoming  subject  to  distension  and  swel- 
ling, like  the  soft  organs,  such  as  membranes,  ten- 
dons, ligaments,  vessels,  and  other  parts  composed 
of  cellular  substance.  Under  such  circumstances, 
if  the  softened  bone  is  exposed  by  the  want  of  an 
outlet  to  the  action  of  acrimonious  fluids,  it  swells, 

P 


114 


ANATOMICAL  INVESTIGATIONS. 


becomes  violently  distended  and  red,  and  soon 
forms  an  irregular  fungous  mass,  similar  to  excre- 
scences of  diseased  flesh.'^  The  phenomena  of 
spina  ventosa  and  psedarthrocace,  are  well  known 
to  surgeons,  the  bones  at  first  softening  so  slightly 
as  by  no  means  to  allow  of  the  introduction  of  a 
probe — at  length  becoming  a sort  of  fieshy  matter, 
the  skin  is  burst  up  and  presents  a wretched  spec- 
tacle— the  tumour  bleeds  on  the  slightest  touch, 
and  pours  out  a fetid  discharge.  This  change  of 
the  bone  into  a substance  similar  to  fiesh,  and  its 
easy  distension,  shows  that  there  is  much  simili- 
tude between  the  cellular  texture  of  the  substance 
of  the  bone,  and  the  common  cellular  texture,  whose 
great  ductility  and  the  facility  with  which  it  forms 
fieshy  tumours,  is  equally  well  known  to  physio- 
logists and  pathologists. 

* In  one  case  to  which  I was  called,  there  was  an  enlargement  of 
the  tibia  about  two  hand-breadth’s  below  its  head,  with  a large  open- 
ing through  wich  an  ill-looking  fleshy  mass  could  be  seen  within,  and 
from  this  opening  a very  unpleasent  discharge  was  kept  up.  The 
patient  about  fifteen  years  old,  sufferred  greatly,  was  extremely 
emaciated,  and  had  regular  hectic  paroxysms.  A probe  could  be 
passed  in  any  direction  through  the  diseased  part  of  the  tibia. 
When  the  foot  was  raised  it  was  evident  that  both  bones  were 
fairly  softened,  and  might  be  bent  almost  to  any  degree.  Am- 
putation was  recommended — some  delay  was  occasioned.  The  pa- 
tient began  to  take  bark  freely  for  the  debility,  and  in  a very 
short  time  entirely  recovered. 


ANATOMICAI.  INVfiSTK^-ATIONS.  115 

Sometimes  it  happens  fortunately,  that  the  bones 
swell  to  an  extraordinary  size,  from  the  softening 
of  their  cellular  strncture,  without  injury  to  the  ani- 
mal. In  fact,  we  think  in  opposition  to  the  com- 
mon opinion  of  surgeons,  that  this  peculiar  soften- 
ing and  germination,  like  fleshy  substance  from 
bones,  is  determined  and  promoted  by  a salutary 
effort  of  nature,  to  repel  injuries  done  to  the  bone, 
or  to  restore  the  continuity  when  it  has  been  bro- 
ken. After  fractures  we  see  the  points  of  broken 
bones  first  grow  soft  by  the  absorption  of  the  earthy 
matter^ — -afterwards  from  these  points,  already  of  a 
cartilaginous  flexibility,  we  perceive  a red  sub- 
stance to  sprout  forth,  called  by  Celsus  caruncula — 
and  this  caruncle  extending  according  to  the  dis- 
placement of  the  broken  bones,  assuming  various 
sizes  and  forms,  connects  the  points  together  and 
fills  up  the  vacancies  caused  by  any  loss  of  sub- 
stance. In  the  living  state  this  caruncle  is  red, 
but  after  death,  being  freed  from  blood  and  mace- 
rated, has  the  appearance  and  character  of  cartila- 
ginous substance..  In  the  living  body  this  carun- 
cle is  well  supplied  with  blood-vessels,  which  de- 
positing earthy  particles,  gradually  impart  greater 
consistence,  and  proper  osseous  character,  when 
the  name  of  callus  is  bestowed  on  the  mass  by'the 
surgeon. 


116  anatomical  investigations. 

In  relation  to  the  organic  nature  of  callus,  my 
own  experiments,  after  those  of  IIetlkf,  Hai  lerj 
Bonn  and  Bohmer,  do  not  allow  me  to  doubt. 
Those  who  have  hitherto  fore  taught  that  callus  was 
something  similar  to  gluten  concreted  with  earthy 
matter,  always  appear  to  me  to  have  very  rude  no- 
tions of  the  animal  economy,  and  have  not  re- 
marked that  callus  once  formed  in  young  animals, 
grows  as  it  advances  in  age  in  the  same  proportion 
as  the  other  bones,  and  is  changed  in  colour  by  the 
use  of  madder,  just  as  they  are.  The  blood-ves- 
sels of  callus  may  be  minutely  injected  : and  in 
short,  callus  when  acted  on  by  mineral  acids,  is 
deprived  of  earthy  matter  and  resolved  into  a car- 
tilaginous substance  similar  to  the  other  undoubted 
bones.  Such  teachers,  moreover,  seem  not  to  have 
observed,  if  it  has  happened  before  them,  that  when 
bones  formerly  joined  and  restored  by  callus  are 
seized  by  rickets  and  softening,  this  callus,  like 
the  other  bones  of  the  animal,  becomes  softened 
and  preternaturally  tumid. 

1 have  removed  from  the  surface  of  the  tibia  in  a 
full  grown  man  soon  after  death,  a portion  of  callus 
almost  four  inches  long  and  one  broad,  still  soft, 
altpgether  cartilaginous  and  easily  cut  with  a 
knife— this  specimen  is  preserved  in  spirits  of  wine. 
Its  external  surface  has  the  appearance  and  form 


ANATOMICAL  INVESTIGATIONS, 


417 


of  the  osseous  crust — but  the  internal  surface  that 
adhered  to  the  tibia,  exhibited  a most  beautiful  net- 
work, which  at  first  sight  could  not  be  distinguished 
from  common  cellular  substance.  By  examining 
this  structure  with  a microscope  of  high  power,  it 
Avas  plainly  demonstrated  to  be  cavernous,  and  al- 
together cellular,  have  many  very  minute  earthy 
particles  in  it,  especially  in  its  external  surface, 
Avhich  was  firmer  and  more  rigid  than  the  opposite 
side. 

It  is  wonderful  to  see  the  celerity  with  which 
the  soft  caruncle,  filled  with  blood-vessels,  shoots 
forth  on  the  bones  of  birds  that  have  been  stripped 
of  periosteum,  first  changing  to  cartilage,  afterwards 
into  a light  downy  bone,  delicately  reticular  both 
externally  and  internally. 

I have  made  the  same  experiments  on  the  bones 
of  kittens,  Avhich  though  not  effected  with  the  same 
celerity,  yet  terminated  in  a similar  manner. 

The  tibia  of  a cat,  from  which  a soft  callus  had 
grown  after  the  periosteum  had  been  removed 
from  two-thirds  of  the  whole  circumference  of  the 
bone,  was  macerated  in  muriatic  acid  until  the 
whole  bone  became  pellucid  and  fiexible.  By 
placing  this  bone  in  oil  of  turpentine,  I found  that 
the  caruncle,  or  rudiment  of  the  future  callus  was 
continued  from  the  cartilaginous  model  of  the  bone, 
and  was  nothing  more  than  a germination  and  intu- 


118  ANATOMICAL  INVESTIGATIONS. 

mescence  of  the  cartilaginous  substance  of  the  tibia. 
I have  seen  the  same  thing  plainly  in  the  tibia  of 
an  adult  man,  who  had  suffered  a vast  laceration  of 
the  soft  parts  and  periosteum,  two  months  before 
death — the  caruncle  was  sufficiently  produced,  and 
part  of  it  had  begun  to  change  to  bone.  When  the 
whole  tibia  was  freed  from  earthy  particles  by  the 
aid  of  mineral  acid,  and  rendered  pellucid,  it  ap- 
peared that  the  perfect  callus,  as  well  as  the  ca- 
runcle, formed  one  and  the  same  substance  with 
the  whole  parenchyma  of  the  tibia — that  is,  the 
cartilaginous  nucleus  of  the  tibia  was  expanded  into 
the  callus,  and  was  prolonged  and  stretched  out 
uncommonly. 

In  another  cat  whose  tibia  was  deprived  of  a 
long  and  broad  portion  of  periosteum,  a recently 
formed  callus  swelled  out — when  I had  filled  the 
arteries  very  minutely  with  red  wax,  this  callus 
was  handsomely  tinged  red,  and  the  colour  was 
distinct  from  that  of  the  rest  of  the  tibia.  But 
when  1 had  removed  the  earthy  matter  by  acids 
from  the  whole  tibia,  and  rendered  it  soft  and  pel- 
lucid, and  examined  it  opposite  to  the  light,  I dis- 
covered an  immense  number  of  blood-vessels  scat- 
tered through  the  callus. 

Besides  the  proofs  heretofore  given,  that  the 
callus  is  formed  by  the  intumescence,  or  germina- 
tion, of  the  parenchymatous  cellular  texture  of  the 


ANATOMICAL  INVESTIGATIONS.  119 

bones,  we  may  add,  that  whether  Ave  consider  the 
formation  of  callus  and  the  process  of  ossification, 
or  look  to  the  minute  structure  when  the  bone  is 
perfected,  ive  shall  find  all  the  circumstances  of 
the  original  ossification  and  formation  of  callus  are 
alike,  '['he  caruncle  does  not  harden  by  the  whole 
quantity  of  earth  being  deposited  at  once,  but  re- 
ceives the  earthy  substance  as  in  the  formation  of 
bone  in  the  incubated  egg,  where  the  blood-vessels 
appear,  carrying  red  blood,  and  supplying  at  the 
same  time  the  necessary  earthy  particles.  Since 
this  condition  of  the  vessels  takes  place  unequally, 
as  well  in  the  cartilaginous  model  of  bones  as  in 
the  rudiment  of  future  callus^  it  hence  necessarily 
happens,  that  in  both,  small  distinct  spots  appear  at 
the  commencement  of  ossifi^cation  without  any  order, 
which  finally  unite  together  in  the  cartilaginous 
model  of  the  embryon,  or  after  fractures  cover  up 
and  take  place  of  the  caruncle.  As  soon  however 
as  the  caruncle  is  wholly  ossified  we  find  the  callus, 
like  the  original  ossification  in  the  incubated  egg, 
entirely  cotton-like,  reticular,  spongy,  and  equally 
light  and  delicate  throughout  its  whole  extent.  It  ap- 
pears as  if  forcibly  compressed,  and  becomes  more 
and  more  condensed  until  it  hardens  and  is  covered 
with  an  external  crust  or  bark,  which  substance,  as 
in  the  bones  of  erabryons  near  the  full  time,  in- 


120 


ANATOMICAL  INVESTIGATIONS. 


creases  more  in  length  in  proportion  to  the  diminu- 
tion of  the  cellulo-reticular  structure. 

The  origin  of  exostosis,  is  undoubtedly  similar 
to  the  formation  of  callus.  For  in  such  cases,  the 
surface  of  the  bone  being,  for  ever  so  small  a dis- 
tance, deprived  of  the  periosteum,  becomes  sof- 
tened, is  followed  by  a germination  of  the  caruncle 
from  this  spot,  which  is  lengthened  and  increased 
from  the  fluids  circulating  in  it — hardens  finally  by 
the  deposition  of  earthy  matter,  and  produces  a tu- 
mour whose  minute  structure  does  not  differ,  in  the 
slightest  degree,  from  that  peculiar  to  the  bones,  if 
we  except  this  circumstance,  that  the  tumour  is 
sometimes  harder  than  the  bone  itself,  in  conse- 
quence of  the  greater  quantity  of  earthy  matter  it 
has  received.  I speak  now  of  the  true  and  legiti- 
mate exostosis,  which  may  have  been  originally 
caused  by  some  virus — and  although  this  has,  by 
treatment  or  spontaneously,  been  removed,  still 
the  exostosis  does  not  cease,  because  the  caruncle 
shooting  from  the  surface  of  the  softened  bone,  ob- 
tains the  nutritious  gluten  along  with  the  earth 
from  the  common  cement,  and  assumes  the  osseous 
character.  A few  years  since  I had  occasion  to  re- 
move the  tibia  and  fibula  near  the  knee,  where  a 
great  exostosis  swelled  out,  in  a man  of  about  forty 
years.  I amputated  the  leg  at  the  usual  distance 


ANATOMICAL  INVESTIGATIONS,  121 

from  the  patella,  through  the  exostosis.  The 
wound  in  a short  time  was  healed  without  being  af- 
fected by  the  exostosis — the  cut  bones  adhering  to 
the  integuments  were  covered  by  a firm  cicatrix. 

Caries  is  separated  from  the  sound  bone  almost 
always  in  the  same  way  that  callus  is  formed.  At 
the  extremities  of  a bone  suffering  under  caries,  the 
earth  is  absorbed  by  the  action  of  the  proper  ves- 
sels, and  from  this  spot  the  caruncle  shoots  forth, 
which  being  treated  with  bland  and  emollient  ap- 
plications, separates  the  carious  bone  in  every  di- 
rection, and  throws  it  off  from  the  sound.  When 
this  happens,  the  caruncle  which,  as  we  have  de- 
monstrated, is  very  vascular,  before  it  wholly  ossi- 
fies, forms  anastomoses  with  the  surrounding  soft 
parts,  and  even  with  the  skin  itself.  On  this  ac- 
count, after  the  cure  has  been  entirely  effected,  we 
find  about  this  caruncle,  that  the  integuments  are  at- 
tached to  the  subjacent  bone,  and  that  there  is  a 
dense  concave  cicatrix  formed  thereby. 

Therefore,  in  addition  to  the  anatomical  re- 
searches and  observations  made  relative  to  the  for- 
mation of  foetal  bones,  and  their  structure  in  adult 
animals,  various  morbid  affections,  the  chief  of 
which  1 have  mentioned  above,  show  that  the  mi- 
nute structure  of  the  hardest  of  these  organs  differs 
very  slightly  from  the  structure  and  properties  of 
cellular  texture,  if  we  except  that  the  common 

Q. 


122  ANATOMICAL  INVESTIGATIONS^ 

cellular  substance  is  very  soft  and  juicy,  and 
the  cellular  texture  of  bones  in  consequence  of  the 
earth  it  receives,  begins  early  to  harden  and  has  its 
strength  and  density  increased  by  the  daily  addi- 
tion of  earthy  matter.  It  is  nevertheless  equally 
certain,  where  the  cellular  texture  of  the  bone  is 
first  deprived  of  its  earthy  particles,  it  becomes 
flexible  and  ductile,  like  many  other  parts  of  ani- 
mals which  are  called  soft  and  distensible,  having 
as  great  an  aptitude  to  swell  or  enlarge  as  the  com- 
mon cellular  substance.  As  sometimes  it  happens 
in  ulcers  which  are  treated  by  an  unskilful  sur- 
geon, by  oily  and  relaxing  remedies  longer  than  is 
proper,  the  cellulous  subcutaneous  texture  swells 
and  rises  above  the  skin  like  a fungus  tumour, 
so  it  naturally  occurs  when  the  cellular  texture  of 
hone  is  deprived  of  its  earthy  matter,  the  same 
vital  action  forms  and  germinates  the  caruncle^ 
which  sometimes  only  unites  the  points  of  a broken 
bone,  and  at  others,  wonderfully  replaces  the  ma- 
terial that  has  been  lost.  The  celebrated  Haller 
formerly  taught,  that  the  cellular  texture  was  the 
great  foundation  of  the  animal  structure,  because 
all  the  membranes  without  exception,  the  vessels 
which  are  hollow  membranes,  the  greatest  part  o-f 
the  viscera,  tendons,  aponeuroses,  ligaments  and 
integuments  of  the  whole  body,  are  made  of  this 
cellular  texture.  This  is  not  only  true,  but  an  ad- 


ANATOMICAL  INVESTIGATIONS.  123 

dition  of  the  boues  may  be  made  to  this  catalogue, 
on  the  authority  of  the  most  careful  observatious. 

I have  taken  care  to  examine  the  minute  anatomy 
of  the  bones  in  other  animals,  as  in  amphibia,  rep- 
tiles, and  fishes.  In  the  great  whale  called  balsena 
mysticetes,  the  cellulo-reticular  structure  is  most 
fully  evident,  both  in  the  bones  of  the  head  and 
shoulder  blades,  and  in  the  cortex  of  the  lower  jaw, 
and  the  longest  of  the  ribs.  There  is  no  great 
acuteness  of  sight  requisite  to  detect  the  same 
structure  in  the  bones  of  the  delphinus  phocaena, 
because  the  reticular  structure  in  this  animal  is 
more  visible,  since  there  is  but  a small  quantity  of 
earthy  matter  concealed  in  it.  The  same  structure 
is  very  manifest  in  the  bones  of  the  sea  turtle,  and 
in  reptiles  of  every  kind.  In  cartilaginous  fishes, 
as  the  shark,  frog-fish,  sting-ray,  and  others  of  the 
same  kind,  whose  bones  contain  even  less  earth 
than  those  of  the  dolphin,  the  reticular  texture  of 
the  cortex  is  also  far  more  conspicuous.  In  the 
scaly  fishes,  as  in  the  pike,  although  the  bones  are 
very  hard  and  contain  much  earth,  yet  the  cellulous 
texture  is  very  perceptible,  and  the  branching  tracts 
concur  at  acute  angles,  wonderfully  and  beautifully 
reticulated. 

The  salutary  changes  which  we  have  mentioned 
heretofore  as  occurring  in  the  bones,  being  effected 
and  continued  by  the  vital  power  and  action  of  the 


-124 


ANATOMICAL  INVESTIGATIONS, 


vessels,  it  follows,  evidently,  that  the  hones, 
besides  the  great  quantity  of  lymphatic  vessels, 
are  also  possessed  of  a vast  number  of  blood- 
vessels, and  are  really  more  vascular  than  any 
one  not  accustomed  to  minute  anatomy  can  have 
any  idea  of.  The  celebrated  Albinus,  indeed, 
taught  a long  time  since,  that  a vast  number  of  ves- 
sels passed  from  the  periosteum  into  the  cortex, 
through  the  numerous  spiracles  of  Havers,  and 
these  vessels,  with  others  of  the  same  character 
running  through  the  medituliium,  properly  called 
nutritious  arteries,  anastomosed,  and  passing  by 
particular  openings  through  certain  parts  of  the 
bony  crust,  enter  the  medullary  cavity,  bestowing 
the  most  minute  ramifications  on  the  marrow  and 
its  membranes.  But  Albinus,  when  he  wrote 
this,  thought  that  the  blood-vessels  immediately 
after  entering  the  pores  of  the  cortex,  went  in  right 
lines  between  the  strata  of  plates  and  tables.  This 
I certainly  know  to  be  far  from  the  truth,  and  fo- 
reign to  the  structure  of  the  bones  and  the  real  dis- 
tribution of  the  blood-vessels.  When  I had  filled 
the  vessels  of  the  bone  in  a young  and  immature 
foetus  with  most  minute  injection,  I found  the  ves- 
sels of  the  periosteum  immediately  on  entering  the 
pores  of  Havers,  not  going  oflT  in  right  lines,  but 
giving  and  receiving  frequent  branches,  encircling 
the  reticulated  structure  of  the  cortex,  and  joining 


ANATOMICAL  INVESTIGATIONS.  125 

each  otKeV  at  the  shortest  intervals,  following  the 
course  of  the  osseous  net-work.  Where  the  cortex 
of  the  bone  internally  began  to  loosen  to  the  spongy 
substance  of  the  meditullium,  the  blood-vessels  of 
the  cortex  also  inclined  to  the  centre,  and  their 
trunks  joined  at  certain  places,  with  those  going 
to  the  marrow,  as  before  stated.  This  seems  to  be 
a wise  provision  of  nature,  that  at  the  same  time 
the  external  crust  of  the  bone  is  supplied  with  a 
large  quantity  of  blood,  a full  and  manifold  com- 
munication should  exist  by  these  almost  innumera- 
ble anastomoses,  between  the  external  and  internal 
structure.  I pointed  out  the  mode  of  distribution 
of  the  blood-vessels  in  bones,  as  shown  by  injec- 
tions, in  the  incubated  egg  of  the  sixteenth  day? 
when  the  red  zones  which  surround  both  the  ex- 
tremities of  the  tibia,  being  broadly  expanded,  meet 
in  the  centre  of  the  bone.  Under  these  circum- 
stances, even  should  the  external  periosteum  be  re- 
moved, the  cortex  of  these  delicate  bones  is  suffused 
with  so  great  a redness  by  the  abundance  of  vessels, 
that  it  seems  to  be  covered  with  a sort  of  sangui- 
neous dew. 

Since  the  bones  enjoy  vitality,  are  nourished  and 
grow'  like  other  parts,  it  is  in  perfect  agreement 
with  analogy  to  believe,  that  besides  the  great 
number  of  blood-vessels,  they  are  supplied  with 
nerves,  although  these  can  scarcely  be  demon- 


126  ANATOMICAL  INVESTIGATIONS. 

strated,  not  only  on  account  of  ther  tenifity,  but 
perhaps^ — because,  as  in  many  other  parts,  the 
very  small  nerves  enter  the  foramina  of  bones  in 
coalescence  with  the  arteries.  But  if  pathological 
observations  may  be  allowed  any  w'eight,  I may 
state,  that  I have  more  than  once  produced  a sense 
of  pain  by  scraping  and  abrading  living  bone.  I 
have  also  observed  that  the  caruncle  which  shoots 
from  the  substance  of  bones  is  endowed  with  sensi- 
bility, and  have  lately  had  a most  excellent  opportu- 
nity of  confirming  this  statement.  On  a part  of  the 
tibia  of  a man,  five  inches  long  and  one  broad,  that 
had  been  removed  by  the  natural  process — I wet  the 
caruncle  with  camphorated  spirits  of  wine,  of  which 
the  patient,  who  was  by  no  means  timid,  complained, 
much — sliortly  after,  1 wet  the  point  of  a soft  pen- 
cil with  spirits  of  sal  ammoniac,  and  when  it  was 
applied  to  the  caruncle,  the  patient  cried  out.  Now 
that  the  caruncle,  which  is  nothing  but  the  bone 
itself  deprived  of  earthy  matter,  is  entirely  insensi- 
ble and  destitute  of  nerves,  it  is  altogether  absurd 
to  assert. 

The  following  questions  may  be  asked  relative 
to  the  minute  anatomy  of  the  bones.  Is  the  diploe 
present  in  the  cranial  bones  of  the  foetus  or  not? 
Are  the  pituitary  sinuses  altogether  wanting  in  the 
bones  of  the  foetus  at  full  time  ? that  is,  are  the 
frontalf  cethmoidal,  maxillary^  and  sphenoidal  si- 


ANATOMICAL  INVESTIGATIONS. 


421 


mises  present?  relative  to  which  anatomists  are 
yet  undecided. 

In  relation  to  the  first  question,  if  any  one  atteii- 
tentively  examines  a perpendicular  section  of  the 
cranial  bones  in  an  immature  foetus,  with  the  aid  of 
a good  glass  he  will  find  a very  singular  and  re- 
markable circumstance.  The  reticulated  cellulous 
texture  of  the  foetal  cranium  on  the  inside  is  already 
solid,  smooth  and  compact,  and  has  already  formed 
that  table  which  is  called  vitreous — but  the  external 
surface  of  the  cranium  still  remains  light,  reticular 
and  flocculent,  as  it  were  surrounded  by  an  osseous 
down.  After  birth,  and  especially  in  childhood, 
this  reticular  down  is  in  greater  quantity,  the  can- 
celli  and  areolse  are  more  and  more  drawn  together, 
and  solidified  into  a thin  crust  under  the  pericra- 
nium. This  crust,  moreover,  envelopes  the  whole 
reticular  substance  of  the  cranium,  and  whatever 
remains  after  the  formation  of  the  two  tables  is  con- 
fined between  them  and  receives  the  name  of  dijploe- 
If  the  ossification  advanced  beyond  the  middle, 
the  portion  of  the  reticulo-cellular  substance  be- 
tween the  two  tables  would  be  added  to  either  the 
external  or  internal,  and  then  the  adult  cranial 
bones  would  be  entirely  without  dijploe,  but  would 
constantly  acquire  a hardness  and  thickness  beyond 
what  is  common.  Wherefore,  so  far  is  it  from  fact 
that  the  diploe  is  wanting  in  the  foetus,  that  it 


428 


ANATOMICAL  INVESTIGATIONS. 


should  rather  be  stated  that  all  the  external  surface 
immediately  under  the  pericranium  is  nothing  hut 
diploe. 

In  relation  to  the  pituitary  sinuses  of  the  nose, 
among  the  dissectors  who  affirm  these  cavities  to  be 
entirely  wanting  in  the  foetus  at  nine  months,  (for 
many  anatomists  are  of  this  belief,)  some  teach  that 
these  receptacles  in  adults  are  to  be  attributed  to 
the  action  of  absorbent  vessels.  For,  say  they,  the 
material  is  absorbed  from  the  middle  of  the  frontal, 
sphenoid  and  maxillary  bones,  and  is  replaced  at 
the  margin  forming  new  and  large  cavities.  I 
freely  confess  that  there  is  much  excellent  testi- 
mony to  prove  the  great  power  which  the  absorbent 
vessels  possess  in  removing  both  fluids  and  solids. 
Nevertheless,  granting  all  this  power  to  the  absor- 
bents, 1 do  not  understand  why  they  do  not  equally 
remove  the  whole  substance  of  the  bone,  as  well  as 
make  local  excavations  at  certain  points.  But  pas- 
sing over  these  disquisitions  and  doubts,  we  cannot 
withhold  our  admiration  at  some  of  the  recent  wri- 
ters on  osteology,  who  deliver  it  as  thoroughly  in- 
vestigated and  certainly  established,  that  these 
sinuses  are  wanting  in  the  foetus  at  birth* — not  re- 

* What  would  Scarpa  think  of  the  positive  assertions  made  very 
recently,  and  worst  of  all,  republished  in  Philadelphia,  that  the 
frontal  sinuses  do  not  exist  in  every  individual— and  that  “ a gen- 


ANATOMICAL  INVESTIGATIONS. 


129 


collecting  that  the  celebrated  Albinus  has  described 
many  of  these  sinuses  in  the  foetus  of  nine  months, 
and  illustrated  them  by  plates.  In  fact  I have  be- 
fore me,  in  a foetus  of  this  age,  the  mthmoid  cells  as 
delineated  by  Albinus,  and  also  the  maxillary  and 
spheno-basilar  sinuses  proportionably  as  distinct  as 
in  the  adult.  The  spheno-basilar  sinus,  at  this 
tender  age,  is  not  only  begun,  but  it  is  already 
fairly  divided  into  two  parts  by  an  interseptum. 
The  frontal  sinus  is  the  only  one  whose  rudiments 
are  obscure  in  the  foetus  of  nine  months,  yet  it  is  not 
entirely  wanting — but  at  that  age  the  frontal  sinus 
is  not  sufficiently  distinct  from  the  sethmoid  cells, 
as  is  shown  by  the  flatness  above  the  nose  in  the 
foetus,  and  the  formation  of  a continued  series  be- 
tween the  frontal  sinus  and  aethraoid  cells  in  the 
adult. 

The  pituitary  sinuses  of  the  nose,  like  many 
other  parts  which  are  delineated  in  the  embryon, 
are  only  evolved  with  the  increment  of  the  whole 
body.  For  the  purpose  of  effecting  this,  in  addition 
to  the  remarkable  powers  through  whose  action  the 
nutrition  and  increase  of  the  animal  organs  are 

tleman  of  the  medical  profession,  who  had  finished  his  studies  at 
Edinburgh, dissected  carefully  at  Paris  for  “ seventeen  months,'” 
and  could  not  find  the  frontal  sinus,  except  in  a single  instance, 
and  that  in  the  head  of  a “mad  woman!!”  See  Combe’s  Essays 
on  Phrenology,  p.  83  passim.  J.  D.  G. 


R 


130  ANATOMICAL  INVESTIGATIONS. 

kept  up,  I think  that  faculty  of  the  animal  economy 
by  which  the  primordial,  light,  reticular,  and  cellu- 
lar texture,  at  certain  places  and  different  periods 
of  time  becomes  more  condensed,  or  relaxed  and 
spongy,  as  may  be  necessary,  does  much  in  the 
increment  and  evolution  of  the  pituitary  sinuses. 
Indeed,  in  the  first  instance,  it  follows  from 
mechanical  necessity,  that  the  cavity  surrounded 
by  the  osseous  sponge,  which  is  contracted  and 
changed  into  a hard  thin  crust,  should  be  increased. 
This  is  certainly  manifest  in  the  cylindrical  bones, 
which  are  spongy  and  cotton-like  throughout  their 
whole  extent  in  the  embryon,  and  as  soon  they 
begin  to  harden  and  form  their  cortex  in  the  middlc;> 
the  tube  of  the  bone  becomes  apparent. 

In  addition  to  the  causes  stated  above,  it  is  very 
probable  that  another  circumstance  takes  place  in 
the  increment  and  evolution  of  the  pituitary  si- 
nuses— that  is,  as  the  body  increases,  the  capacity 
of  these  sinuses  gradually  enlarges,  and  the  extent 
of  the  spongy  bone  surrounding  them  is  increased, 
at  the  same  time  its  thickness  is  diminished,  until 
this  bony  sponge  forms  the  walls  of  the  pituitary 
sinus.  There  will  be  less  doubt  in  relation  to  this, 
if  skulls  of  all  ages,  from  the  foetus  at  birth  to  the 
adult,  be  carefully  examined,  in  which  it  is  very 
manifest  that  the  amplitude  of  these  sinuses  are  in 
the  inverse  ratio  of  the  spongy  celliilous  substance 


ANATOMICAL  INVESTIGATIONS. 


ISi 


oF  the  bone,  which  in  the  foetus  surrounds  these  ca- 
vities. But  to  these  causes  promoting  the  increment 
of  the  pituitary  sinuses  that  may  be  properly  called 
jprimary,  I think  that  those  secondary  cases  should 
be  added,  depending  from  the  change  of  figure  and 
position  which  the  surrounding  bones  of  the  em- 
bryon  are  subject  to. 

The  convexity  of  the  superior  and  middle  turbi- 
nated bones  being  increased  towards  the  septum 
narium,  favours  the  expansion  of  the  sethmoid  cells, 
and  the  appearance  of  the  molar  teeth  in  tlie  child, 
with  an  increased  convexity  of  the  alveolar  process, 
aids  much  in  developing  the  maxillary  sinus — in 
proof  of  which,  the  maxillary  cavity  is  much  les- 
sened when  the  molares  fall  out,  and  the  alveolar 
arch  is  removed.  When  the  root  of  the  nose  and 
and  outer  surface  of  the  frontal  bone  is  raised  in 
children,  this  causes  the  sethmoid  cells  to  be  raised 
upwards  along  with  them,  so  that  the  superior  cells 
get  a new  place  and  name,  and  are  called  frontal 
sinuses.  Should  any  one  suppose  the  air  during 
respiration  to  be  impelled  throughout  these  sinuses, 
I should  not  be  much  disposed  to  object.*  I will 

* The  air  has  access  to  the  sinuses  during  respiration,  when  they 
are  not  diseased — ^but  it  is  not  necessarily  changed  at  every  breath- 
ing, as  is  evinced  by  the  occasional  retention  of  a peculiar  odouj 
which  is  proved  by  its  re-appearance  after  a lapse  of  time,  and  oui 
removal  from  the  spot  where  it  w'as  first  experienced.  J.  D.  G. 


132 


ANATOMICAL  INVESTIGATIONS. 


end  this  essay  by  pointing  out  the  propriety,  ia 
similar  researches,  in  order  to  understand  the  most 
iut'eresting  articulations  of  the  body,  of  employing 
a recent  subject  in  which  the  bones  are  held  toge* 
ther  by  their  own  peculiar  ligaments.  Experience 
has  taught  me  that  dissectors  have  often  fallen  into 
error,  from  want  of  a recent  subject  before  them  to 
examine  and  correct  their  notions. 

In  dried  bones,  for  instance,  deprived  of  their 
ligaments,  any  one  would  say,  judging  from  the 
appearance  of  the  head  of  the  bone  and  the  aceta- 
bulum, that  a man  could  readily  move  the  thigh 
bone  ill  every  direction — could  flex,  extend,  adduct, 
or  draw  one  thigh  to  the  other.  Noth  withstanding, 
I venture  to  assert,  that  it  is  most  certain  we  have 
not  the  power  of  extending  the  femur,  that  is,  to 
carry  it  behind  the  perpendicular  line  of  the  whole 
body.  If  we  stand  on  one  foot,  and  attempt  to 
move  the  thigh  behind  the  perpendicular  jine  of  the 
body,  we  find  that  we  are  altogether  unable  to  ac- 
complish it,  and  if  we  appear  at  all  to  succeed,  it  is 
only  in  proportion  as  we  bend  the  trunk  forwards 
above  the  hip  joint.  The  unequal  thickness  of  the 
capsular  ligament  of  the  hip  joint,  and  the  peculiar 
disposition  and  insertion  of  this  ligament  into  the 
neck  of  the  femur,  prevents  the  extension.^ 

* By  reference  to  the  description  given  in  the  previous  part  of 
of  this  volume  of  the  manner  in  which  the  capsular  ligament  of  the 


ANATOMICAL  IN'VESTIGATION  S. 


133 


The  capsular  ligament  below  the  psoas  magnus 
and  iliacus  interna  s is  very  thin,  and  is  thinnest 
behind,  where  it  is  covered  by  the  quadratus  fe- 
moris.  But  on  the  outer  part  where  the  capsular 
ligament  is  thickest  and  densest,  it  does  not  go  di- 
rectly downwards,  but  passes  obliquely  from  the 
outer  part  of  the  brim  of  the  acetabulum,  and  is  in- 
serted in  the  interior  surface  of  the  root  of  the  neck 
of  the  thigh  bone.f  On  account  of  this  insertion, 
as  we  attempt  to  carry  the  femur  backwards,  the 
anterior,  which  is  firmer  and  denser  than  the  pos- 
terior part,  is  strained  to  the  utmost  and  forcibly 
extended,  preventing  entirely  the  tension  beyond 
the  perpendicular  line.  That  this  principally  de- 
pends on  the  unequal  thickness  of  the  capsular  li- 
gament, is  shown  and  proved  by  opening  this  liga- 
mentous capsule  on  the  side  of  the  foramen  ovale, 
and  thence  introducing  a knife  so  that  the  round  li- 
gament may  be  divided — nevertheless,  although  in 
the  most  recent  subject,  we  cannot  perceptibly  move 

hip  joiut  is  formed  from  the  fascia  lata,  the  reader  will  be  better 
able  to  perceive  the  correctness  of  Scarpa’s  assertions,  inasmuch  as 
he  will  find  another  reason. for  their  truth  in  the  connexion  which 
all  the  muscles  of  the  thigh  have  with  the  capsule.  He  will  also 
he  well  prepared  to  understand  the  cause  of  the  inequalities  in  the 
thickness  of  this  ligament.  J.  D.  G. 

t See  Weitbrecht,  Syndesmologia,  Tab.  xviii.  fig.  53.  God- 
man’s  Jinalomical  Invesligalions^  Sec.  v. 


1S4  ANATOMICAL  INVESTIGATIONS. 

it  backwards  beyond  the  perpendicular  line.  . How 
much  these  facts  will  assist  in  more  clearly  under- 
standing the  circumstances  which  in  health  to  per- 
tain to  the  mechanism  of  standing,  walking,  leap- 
ing, or  in  disease,  to  the  diagnosis  and  removal  of 
luxations  of  the  thigh,  it  is  unnecessary  for  me  to 
point  out  to  any  one  at  all  acquainted  with  the  sub- 
ject. 


ERRATA, 


Pag«  6,— 3d  line  from  top{  after  “ than”  strike  out  “ to.” 

16, — 4th  line  from  the  bottom,  for  “ ileum”  read  ilium. 

45, — 9th  line  from  the  bottom,  for  “ then”  read  than. 

A!T, — for  “ prostrata”  read  prostatx. 

51, — 3d  line  from  bottom,  for  “ prostrate”  read  prostate. 

55, — 6th  line  from  bottom,  for  “ conversity”  read  convexity, 
73, — 2d  line  of  the  note,  for  “ display”  read  displays. 


I 

Godman 

1824 


